Postmortem analysis of cardiovascular deaths in schizophrenia: A 10-year review
Abstract
Schizophrenia is a devastating mental disorder, associated with mortality rates up to three times higher than those in the general population. This post-mortem study sought to investigate the causes of death in a consecutive series of schizophrenia cases, with a specific focus on cardiovascular disease and sudden death. A 10-year review of autopsies in schizophrenia related-cases performed at the Department of Forensic Medicine in Sydney, Australia was undertaken. Premorbid clinical and demographic information was recorded, as well as the key pathological findings and final cause of death. From 2003 to 2012, there were 19,478 postmortem examinations performed of which 683 (3.5%) were deaths in people with a history of schizophrenia. In these cases, the mean age at death was 51years (range 18-93years), with 43% in the 41-60year age group. Males comprised 67% of cases. Overall, 62% of cases had a BMI≥25kg/m(2), indicating overweight or obese individuals. The three primary causes of death were "cardiovascular" (23%), "suicide" (20%), and "drug toxicity" (17%). In 11% of cases (n=72), no definitive cause of death was found, the so-called "unexplained" cases. In conclusion, patients with schizophrenia have premature mortality. The major contributing factors include cardiovascular diseases, suicide and drug toxicity. The "unexplained" and frequently sudden deaths may suggest underlying cardiac arrhythmias as a cause of death in a subgroup of schizophrenia patients.
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In a 10-year postmortem study, cardiovascular disease accounted for nearly a quarter of deaths in schizophrenia, while about 11% remained unexplained even after autopsy.
“In a 10-year postmortem study, cardiovascular disease accounted for nearly a quarter of deaths in schizophrenia, while about 11% remained unexplained even after autopsy, pointing to the role of occult arrhythmogenic mechanisms [7].”
From Trends in Sudden Death Among Schizophrenia Inpatients (2025) · cites this paper as [7]
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“In a 10-year postmortem study, cardiovascular disease accounted for nearly a quarter of deaths in schizophrenia, while about 11% remained unexplained even after autopsy, pointing to the role of occult arrhythmogenic mechanisms [7].”
- Authors
- Sweeting, J., Duflou, J., & Semsarian, C.
- Affiliations
- Centenary Institute (AU)
- The University of Sydney (AU)
- Corresponding author
- Semsarian, Christopher
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 150
- Issue
- 2-3
- Pages
- 398-403
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W1988072863
- Cited by
- 50
- References
- 36
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 6 · 2023: 1 · 2022: 7 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 6 · 2017: 1 · 2016: 4 · 2015: 4 · 2014: 2
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Splash of Red Foundation Scholarship
- National Health and Medical Research Council (NHMRC) Practitioner Fellowship
- 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 › Radiology, Nuclear Medicine and Imaging › Autopsy Techniques and Outcomes
- Keywords
- schizophrenia, cardiovascular disease
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Cardiovascular Diseases, Cause of Death, Death, Sudden, Diagnosis, Female, Humans, Longitudinal Studies, Male, Middle Aged, Retrospective Studies, Risk Factors, Schizophrenia, Suicide, Chi-Square Distribution, Young Adult
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