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. 2021 Apr 29;47(3):864-874.
doi: 10.1093/schbul/sbaa180.

Mortality After the First Diagnosis of Schizophrenia-Spectrum Disorders: A Population-based Retrospective Cohort Study

Paul Kurdyak  1   2   3 , Emilie Mallia  1   2 , Claire de Oliveira  1   2 , Andre F Carvalho  1 , Nicole Kozloff  1   2 , Juveria Zaheer  1 , Wanda M Tempelaar  1 , Kelly K Anderson  2   3   4 , Christoph U Correll  5   6   7 , Aristotle N Voineskos  1   2
Affiliations

Mortality After the First Diagnosis of Schizophrenia-Spectrum Disorders: A Population-based Retrospective Cohort Study

Paul Kurdyak et al. Schizophr Bull. .

Abstract

There is emerging evidence of high mortality rates after the first diagnosis of psychotic disorder. The objective of this study was to estimate the standardized mortality ratio (SMR) in a population-based cohort of individuals with a first diagnosis of schizophrenia-spectrum psychotic disorder (SSD). The cohort included a population-based sample of individuals with a first diagnosis of SSD based on the first diagnosis occurring during hospitalization or in an outpatient setting between 2007 and 2010 in Ontario, Canada. All patients were followed for 5 years after the first diagnosis. The primary outcome was SMR, including all-cause, suicide-related, accidental, and other causes. Between 2007 and 2010, there were 2382 patients in the hospitalization cohort and 11 003 patients in the outpatient cohort. Over the 5-year observation period, 97 (4.1%) of the hospitalization cohort and 292 (2.7%) of the outpatient cohort died, resulting in an SMR of 13.6 and 9.1, respectively. In both cohorts, suicide was the most common cause of death. Approximately 1 in 25 patients with a first diagnosis of SSD during hospitalization, and 1 in 40 patients with a first diagnosis of SSD in an outpatient setting, died within 5 years of first diagnosis in Ontario, Canada. This mortality rate is between 9 and 13 times higher than would be expected in the age-matched general population. Based on these data, timely access to services should be a public health priority to reduce mortality following a first diagnosis of an SSD.

Keywords: first episode; mortality; schizophrenia.

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Figures

Fig. 1.
Fig. 1.
Five-year survival after cohort entry.
None
See this image and copyright information in PMC

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