The DOI matches its Crossref record; 90 of the 90 references it cites were found in a registry or an index.
A Systematic Review of Mortality in Schizophrenia: Is the Differential Mortality Gap Worsening Over Time?
Abstract
CONTEXT: Despite improvements in mental health services in recent decades, it is unclear whether the risk of mortality in schizophrenia has changed over time. OBJECTIVE: To explore the distribution of standardized mortality ratios (SMRs) for people with schizophrenia. DATA SOURCES: Broad search terms were used in MEDLINE, PsychINFO, Web of Science, and Google Scholar to identify all studies that investigated mortality in schizophrenia, published between January 1, 1980, and January 31, 2006. References were also identified from review articles, reference lists, and communication with authors. STUDY SELECTION: Population-based studies that reported primary data on deaths in people with schizophrenia. DATA EXTRACTION: Operationalized criteria were used to extract key study features and mortality data. DATA SYNTHESIS: We examined the distribution of SMRs and pooled selected estimates using random-effects meta-analysis. We identified 37 articles drawn from 25 different nations. The median SMR for all persons for all-cause mortality was 2.58 (10%-90% quantile, 1.18-5.76), with a corresponding random-effects pooled SMR of 2.50 (95% confidence interval, 2.18-2.43). No sex difference was detected. Suicide was associated with the highest SMR (12.86); however, most of the major causes-of-death categories were found to be elevated in people with schizophrenia. The SMRs for all-cause mortality have increased during recent decades (P = .03). CONCLUSIONS: With respect to mortality, a substantial gap exists between the health of people with schizophrenia and the general community. This differential mortality gap has worsened in recent decades. In light of the potential for second-generation antipsychotic medications to further adversely influence mortality rates in the decades to come, optimizing the general health of people with schizophrenia warrants urgent attention.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Research into the health effects of recession has suggested that consequences will be most severe for the poorest groups in society and will have the most impact where social safety-nets are lacking and public hardship grows rapidly.64,65”
From Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014 (2017) · cites this paper as [64]
In the citing paper
“An elevated mortality rate among persons with schizophrenia was indicated by cause-specific SMRs that were higher than 1, except for the SMR for cerebrovascular disease, which was based on only three studies.”
From Excess early mortality in schizophrenia. (2014) · cites this paper as Saha et al. 2007
In the citing paper
“Another interesting result was that the SMRs increased significantly during three recent decades, i.e., the seventies, eighties, and nineties; from 1.84, to 2.98, to 3.20, respectively.”
From Excess early mortality in schizophrenia. (2014) · cites this paper as Saha et al. 2007
In the citing paper
“The overall SMR was 2.58, with 10% and 90% quantiles of 1.18 and 5.76, respectively.”
From Excess early mortality in schizophrenia. (2014) · cites this paper as Saha et al. 2007
In the citing paper
“a recent meta-analysis estimated that the risk of suicide was approximately 13-fold higher for persons with schizophrenia as compared to the general population (Saha et al. 2007).”
From Excess early mortality in schizophrenia. (2014) · cites this paper as Saha et al. 2007
In the citing paper
“Evidence has suggested that antipsychotics are responsible for some of the excess mortality among persons with schizophrenia, especially since the introduction in the late 1990s of second-generation antipsychotics (Saha et al. 2007).”
From Excess early mortality in schizophrenia. (2014) · cites this paper as Saha et al. 2007
In the citing paper
“On the other hand, other studies found an increased (9,21,28,(449)(450)(451) or no different (292,419,452,453) overall risk of cancer in patients with schizophrenia compared to the general population.”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [28]
In the citing paper
“This mortality gap translates into a 10-20 year shortened life expectancy (3,4) and appears to be widening (5).”
In the citing paper
“People with schizophrenia and other psychotic disorders die earlier than their peers in the general population, with recent estimates suggesting by around 15–20 years.1–10”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [9]
In the citing paper
“Evidence as to whether excess mortality is predominantly due to unnatural or natural causes of death remains equivocal.2,7,9,12”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [9]
In the citing paper
“Further, most studies conducted to date have compared mortality in psychosis with that in the national rather than local population,9 thereby ignoring geographical variation in mortality rates.17,18”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [9]
In the citing paper
“Our findings suggest that the mortality gap in people with schizophrenia and other psychoses remains high and may be wider for unnatural-cause mortality than reported in earlier studies”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [9]
In the citing paper
“Over the past decades, consistent evidence has accrued that people with psychotic disorder have higher mortality rates than the general population.1–9”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [9]
In the citing paper
“The SMRs for unnatural-cause mortality (and suicide) that we found in the ӔSOP cohort are markedly higher than the median SMRs of 7.5 for unnatural causes (and 12.9 for suicide) reported in the systematic review by Saha et al,9”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [9]
In the citing paper
“we noted period effects suggestive of a widening mortality gap, insofar as a greater relative all-cause mortality risk was observed for the decade of follow-up for this cohort than that reported for earlier de- cades.4,9,12,35,36”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [9]
In the citing paper
“people with psychosis still do not appear to be benefitting from improvements in healthcare available to the general population.9,34”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [9]
Citations
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Meta-analysis of Observational Studies in Epidemiology<SUBTITLE>A Proposal for Reporting</SUBTITLE>
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623
Murray, C. J. L., & López, A. D. (1997) · The Lancet · doi:10.1016/s0140-6736(96)07492-2 · Cited by 7,007
Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia
Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., Keefe, R. S. E., Davis, S. M., Davis, C. E., Lebowitz, B. D., et al. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa051688 · Cited by 5,892
The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men
Lakka, H.-M. (2002) · JAMA · doi:10.1001/jama.288.21.2709 · Cited by 5,033
Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study
Murray, C. J., & Lopez, A. D. (1997) · The Lancet · doi:10.1016/s0140-6736(96)07495-8 · Cited by 4,492 · cited 1×
“I T IS NOW WIDELY ACKNOWLedged that schizophrenia contributes substantially to the global burden of disease.(1,2) It is also well known that schizophrenia is associated with elevated suicide rates.”
BackgroundMortality by cause for eight regions of the world: Global Burden of Disease Study
Murray, C. J., & Lopez, A. D. (1997) · The Lancet · doi:10.1016/s0140-6736(96)07493-4 · Cited by 4,043 · cited 1×
“I T IS NOW WIDELY ACKNOWLedged that schizophrenia contributes substantially to the global burden of disease.(1,2) It is also well known that schizophrenia is associated with elevated suicide rates.”
BackgroundThe world health report 2001 - Mental health: new understanding, new hope
Sayers, J. (2001) · Europe PMC (PubMed Central) · doi:10.1590/s0042-96862001001100014 · Cited by 3,307
Dementia Praecox and Paraphrenia.
(1972) · Annals of Internal Medicine · doi:10.7326/0003-4819-76-6-1058_8 · Cited by 2,907
A Systematic Review of the Prevalence of Schizophrenia
Saha, S., Chant, D., Welham, J., & McGrath, J. (2005) · PLoS Medicine · doi:10.1371/journal.pmed.0020141 · Cited by 2,168
Self-citation
Cited by
Sorted by citations
Biological insights from 108 schizophrenia-associated genetic loci
Schizophrenia Working Group of the Psychiatric Genomics Consortium (2014) · Nature · doi:10.1038/nature13595 · Cited by 7,577
Age at onset of mental disorders worldwide: Large-scale meta-analysis of 192 epidemiological studies
Solmi, M., Radua, J., Olivola, M., Croce, E., Soardo, L., Salazar de Pablo, G., Il Shin, J., Kirkbride, J. B., Jones, P., Kim, J. H., et al. (2022) · Molecular Psychiatry · doi:10.1038/s41380-021-01161-7 · Cited by 3,835
Walker, E. R., McGee, R. E., & Druss, B. G. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.2502 · Cited by 2,976
DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488
Schizophrenia: A Concise Overview of Incidence, Prevalence, and Mortality
McGrath, J., Saha, S., Chant, D., & Welham, J. (2008) · Epidemiologic Reviews · doi:10.1093/epirev/mxn001 · Cited by 2,280
Self-citation
Metadata
- Authors
- Saha, S., Chant, D., & McGrath, J.
- Affiliations
- Park Centre for Mental Health (AU)
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2007-10-01
- Volume
- 64
- Issue
- 10
- Pages
- 1123
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2149288810
- Cited by
- 2,065
- References
- 90
- Citations by year
- 2026: 41 · 2025: 51 · 2024: 82 · 2023: 74 · 2022: 104 · 2021: 119 · 2020: 119 · 2019: 126 · 2018: 123 · 2017: 174 · 2016: 152 · 2015: 151 · 2014: 138 · 2013: 144 · 2012: 118
- FWCI
- 49.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- schizophrenia, mortality, standardized mortality ratio, all-cause mortality, suicide, causes of death, mortality trends, atypical antipsychotics, health disparities, mental illness
- MeSH terms
- Cause of Death, Cross-Cultural Comparison, Data Collection, Female, Forecasting, Health Status, Humans, Male, Mortality, Risk Factors, Schizophrenia, Sex Factors, Suicide, Antipsychotic Agents, Meta-Analysis as Topic, Developed Countries
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
