CoChat
Sign Up
Cited by 913Schizophrenia research and treatmentSuicide and Self-Harm StudiesMental Health and Psychiatry

The DOI matches its Crossref record; 131 of the 132 references it cites were found in a registry or an index; 29 of the 137 sources its claims cite were checked for support.

Excess early mortality in schizophrenia.

Open access
Laursen, Thomas Munk, Nordentoft, Merete, Mortensen, Preben Bo·2014·Annual Review of Clinical Psychology
DOI 10.1146/annurev-clinpsy-032813-153657
Open this paper in CoChat — free accountOpen PDF

Abstract

Schizophrenia is often referred to as one of the most severe mental disorders, primarily because of the very high mortality rates of those with the disorder. This article reviews the literature on excess early mortality in persons with schizophrenia and suggests reasons for the high mortality as well as possible ways to reduce it. Persons with schizophrenia have an exceptionally short life expectancy. High mortality is found in all age groups, resulting in a life expectancy of approximately 20 years below that of the general population. Evidence suggests that persons with schizophrenia may not have seen the same improvement in life expectancy as the general population during the past decades. Thus, the mortality gap not only persists but may actually have increased. The most urgent research agenda concerns primary candidates for modifiable risk factors contributing to this excess mortality, i.e., side effects of treatment and lifestyle factors, as well as sufficient prevention and treatment of physical comorbidity.

Overview

Integrity signals

Registry

Crossref · 10.1146/annurev-clinpsy-032813-153657

Cites

131 of 131 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

29 of 137 cited sources checked · 16 supported · 1 flagged · accuracy not yet measured

  • Study design and conductcitation

    Large differences exist between the effects achieved in the studies.

    “Note that large differences exist between the effects achieved in the studies (Bonfioli et al. 2012, Caemmerer et al. 2012).”
    • Also stated in: § Diet and Weight · plain
      “Large differences exist between the effects achieved in the studies.”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites Bonfioli et al. 2012 source

      In Results (‘Results for all interventions’; page unavailable), the paper says its test failed to suggest substantial heterogeneity in effects. Its ‘Heterogeneity of studies’ section describes differences in samples and interventions, but says the analysis did not detect statistically significant heterogeneity. Those differences do not establish the claimed large differences between effects. (LLM, conf=0.86)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites Caemmerer et al. 2012 source
  • Premisecitation

    A UK study found life expectancy reduced by 14.6 years among persons with schizophrenia.

    “A recent study from the United Kingdom (Chang et al. 2011) found that life expectancy was reduced by 14.6 years among persons with schizophrenia.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Chang et al. 2011 source

      The Results report a 14.6-year reduction in life expectancy at birth for men with schizophrenia compared with national norms. The citing sentence omits that this figure applies to men; the reported reduction for women with schizophrenia was 9.8 years. (LLM, conf=0.93)

      Experimental — accuracy not yet measured
  • Premisecitation

    A Welsh study found persons admitted with schizophrenia to an asylum from 1875 to 1924 died 10.8 years earlier than the general population.

    “A Welsh study found that persons admitted with schizophrenia to an asylum from 1875 to 1924 died 10.8 years earlier than the general population (Healy et al. 2012).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Healy et al. 2012 source

      The Population section identifies a North Wales asylum cohort admitted from 1875 to 1924. Results > Years of life lost reports 10.8 years lost for patients with schizophrenia whose deaths were confirmed, but 8.0 years when discharged patients were included. The citing sentence omits that qualification and presents 10.8 years as the figure for everyone admitted with schizophrenia. (LLM, conf=0.90)

      Experimental — accuracy not yet measured
  • Premisecitation

    Some studies did not find a reduction in cardiovascular drug use in schizophrenia.

    “However, some studies did not find a reduction in cardiovascular drug use (Desai et al. 2002, Plomondon et al. 2007).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Desai et al. 2002 source
    • cites Plomondon et al. 2007 source

      The Results report similar discharge prescription rates for aspirin, ACE-inhibitors/ARBs, and β-blockers in patients with and without severe mental illness. Schizophrenia was included in the severe-mental-illness group, but the reported medication comparison was for the pooled group, not for patients with schizophrenia separately. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Premisecitation

    A British study found an MRR of 2 to 3.

    “In the British study, an MRR of 2 to 3 was found.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Brown et al. 2010 source
  • It may state two separate claims as one. 69
  • The quote only partly states this claim. 1
  • Probably not a substantial claim. 56

  • It may state two separate claims as one. The quote only partly states this claim.

    Premisecitation

    Schizophrenia is one of the most severe and disabling disorders worldwide, primarily because of very high mortality rates.

    “Schizophrenia is often referred to as one of the most severe mental disorders, primarily because of the very high mortality rates of those with the disorder.”
    • Also stated in: § INTRODUCTION · hedged
      “the data nevertheless indicate that schizophrenia is one of the most severe and disabling disorders worldwide.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Salomon et al. 2012 source

      The Results (page not provided) identify acute schizophrenia as one of the health states with the highest disability weights, supporting the severity aspect of the claim. They do not say that schizophrenia has very high mortality rates or that mortality is the primary reason for its severity; the paper’s mortality comparison concerns disability weights generally. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • It may state two separate claims as one.

    Premisecitation

    The same widening of the mortality gap was found in another Danish study and in a UK study.

    “The same widening of the mortality gap was found in another Danish study (Nielsen et al. 2013b) and in a study from the United Kingdom (Brown et al. 2010).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Nielsen et al. 2013b

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Brown et al. 2010 source

      The Results (Time trends in mortality; page unavailable) show a rise in cardiovascular mortality relative to the general population, but the trend was of borderline statistical significance. The all-cause mortality ratio changed only slightly and not significantly (P=0.6), so the paper does not establish the unqualified widening of the mortality gap attributed to the UK study. (LLM, conf=0.87)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    Saha et al. systematic review found lifetime morbidity risk of schizophrenia 7.2 per 1,000 persons, with 10% and 90% quantiles 3.1 and 27.1, and huge difference across studies.

    “A systematic review by Saha et al. (2005) found a lifetime morbidity risk of 7.2 per 1,000 persons; the 10% and 90% quantiles were 3.1 and 27.1, respectively.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Saha et al. 2005 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    In a large worldwide study, 220 disorders were assigned disability weights; schizophrenia in an acute state had a score of 0.76, the most severe of all 220.

    “However, the most severe of all 220 disorders was schizophrenia in an acute state, with a score of 0.76.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Salomon et al. 2012 source

      The Findings report that acute schizophrenia had the highest disability weight, 0.76, among the 220 assessed. However, the paper calls these 220 entities health states, not 220 distinct disorders; the Results note that a single disorder could have multiple severity states. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Immigrants have a higher incidence of schizophrenia.

    “as do immigrants (Cantor-Graae et al. 2003).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Cantor-Graae et al. 2003 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Lawrence et al. 2010 concluded insufficient health service for schizophrenic patients with cardiovascular disease may explain part of increased mortality from natural causes.

    “Lawrence et al. (2010) concluded that insufficient health service for schizophrenic patients with cardiovascular disease may explain part of the increased mortality from natural causes.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Lawrence et al. 2010 source

  • Probably not a substantial claim.

    Premisecitation

    Mitchell & Lord 2010 concluded evidence supports that deficits in quality of care contribute to higher-than-expected mortality in people with schizophrenia.

    “Mitchell & Lord (2010) reviewed papers on invasive cardiac procedures and medication and concluded that evidence supports that deficits in quality of care contribute to higher-than-expected mortality in people with schizophrenia.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Mitchell & Lord 2010 source

  • It may state two separate claims as one.

    Premisecitation

    Two meta-analyses indicated that weight management programs could impede weight gain during antipsychotic treatment and could also be effective for weight loss.

    “Two meta-analyses (Bonfioli et al. 2012, Caemmerer et al. 2012) indicated that weight management programs could impede weight gain during antipsychotic treatment and could also be effective for weight loss.”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites Bonfioli et al. 2012 source
    • cites Caemmerer et al. 2012 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Daumit et al. (2013) found further support in a randomized controlled trial for weight loss through weight management programs.

    “After the publication of the meta-analyses (Bonfioli et al. 2012, Caemmerer et al. 2012), Daumit et al. (2013) found further support in a randomized controlled trial for weight loss through weight management programs.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Daumit et al. 2013 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Interpretationcitation

    Suicide attempt should be considered a very important risk factor among patients with schizophrenia and other mental disorders.

    “In addition, suicide attempt should be considered a very important risk factor among patients with schizophrenia and other mental disorders, as underlined by the recent findings in a large Swedish study (Runeson et al. 2010).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Runeson et al. 2010 source

  • Probably not a substantial claim.

    Premisecitation

    According to the theory of accelerated aging, physiological changes associated with aging occur at an earlier age in people with schizophrenia compared to the general population.

    “According to this theory, physiological changes associated with aging occur at an earlier age in people with schizophrenia compared to the general population (Kirkpatrick et al. 2008).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Kirkpatrick et al. 2008 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Dutta et al. (2010) estimated a lifetime risk of suicide of 3.23% for patients 20 years after the first psychotic diagnosis.

    “Recently, Dutta et al. (2010) estimated a lifetime risk of suicide of 3.23% for patients 20 years after the first psychotic diagnosis.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Dutta et al. 2010 source

      Table 4 reports a 3.23% cumulative suicide risk for the entire cohort at 20 years after the first psychotic episode. It does not establish 3.23% as a lifetime risk: the paper cautions about that term, and its Results report suicides after 20 years of follow-up. The study measures time from first presentation or episode, rather than first diagnosis. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    An alternative explanation of the early excess mortality in persons with schizophrenia has been the theory of accelerated aging.

    “An alternative explanation of the early excess mortality in persons with schizophrenia has been the theory of accelerated aging.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Kirkpatrick et al. 2008 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    The American Schizophrenia Patient Outcomes Research Team recommends weight management for patients with schizophrenia and a BMI higher than 25.

    “The American Schizophrenia Patient Outcomes Research Team recommends weight management for patients with schizophrenia and a BMI higher than 25 (Dixon et al. 2010); however, it is not clear how these weight management programs should be administered.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Dixon et al. 2010 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Daumit et al. (2013) report a 3.2 kg weight loss in a randomized controlled trial that examines the outcome of a tailored weight management program versus standard treatment in a group of patients with schizophrenia and other severe mental disorders and with a mean body mass index of 36.3 kg/m2.

    “A similar approach focusing on obesity has been evaluated by Daumit et al. (2013), who report a 3.2 kg weight loss in a randomized controlled trial that examines the outcome of a tailored weight management program versus standard treatment in a group of patients with schizophrenia and other severe mental disorders and with a mean body mass index of 36.3 kg/m 2 .”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Daumit et al. 2013 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    Approximately 1.5% of the Danish population will get a diagnosis of schizophrenia at some point in life.

    “From Danish population registries, we know that approximately 1.5% of the population will get a diagnosis of schizophrenia at some point”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Thorup et al. 2007 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingown data

    In Denmark, incidence of schizophrenia peaks in the late teens and early twenties and is more pronounced among males than females.

    “A sharp peak occurs in the late teens and early twenties and is more pronounced among males than females.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    In Denmark, incidence of schizophrenia declines steadily after age 22, and at age 60-61 is 0.1 new cases per 1,000 years under risk in both men and women.

    “The incidence declines steadily after the age of 22, and at the maximum age of this cohort, 60 to 61 years, the incidence is 0.1 new cases of schizophrenia per 1,000 years under risk in both men and women.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    The data also show that these individuals want to stop smoking, eat more healthily, and be more physically active just as much as the general population does.

    “However, the data also show that these individuals want to stop smoking, eat more healthily, and be more physically active just as much as the general population does.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingnone given

    They associate better health with a more meaningful daily life and better quality of life.

    “They associate better health with a more meaningful daily life and better quality of life.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingnone given

    The most significant barriers to changing their lifestyle are the symptoms of the mental illness and the adverse drug effects of medical treatment, but individuals with mental illness are also challenged by a life situation characterized by social isolation and difficulties with creating a structured life.

    “The most significant barriers to changing their lifestyle are the symptoms of the mental illness and the adverse drug effects of medical treatment, but individuals with mental illness are also challenged by a life situation characterized by social isolation and difficulties with creating a structured life.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim.

    Findingnone given

    Mortality rate ratio for persons with schizophrenia in Denmark compared to the general population.

    “Mortality rate ratio for persons with schizophrenia (solid line) in Denmark compared to the general population (reference group; dotted line).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingnone given

    Incidence of schizophrenia among women and men, ages 13 to 60, per 1,000 years under risk in Denmark in the period 1995 to 2011.

    “Incidence of schizophrenia among women (solid line) and men (dotted line), ages 13 to 60, per 1,000 years under risk in Denmark in the period 1995 to 2011.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim.

    Findingnone given

    Incidence rate ratios of 19 somatic chronic diseases included in the Charlson Comorbidity Index among persons previously admitted with schizophrenia to a Danish psychiatric hospital compared to the general population without psychiatric hospital contact.

    “Incidence rate ratios of 19 somatic chronic diseases included in the Charlson Comorbidity Index among persons previously admitted with schizophrenia to a Danish psychiatric hospital compared to the general population without psychiatric hospital contact.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    The mortality gap in schizophrenia not only persists but may actually have increased.

    “Thus, the mortality gap not only persists but may actually have increased.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationcitation

    High mortality in schizophrenia is found in all age groups, resulting in life expectancy approximately 20 years below that of the general population.

    “High mortality is found in all age groups, resulting in a life expectancy of approximately 20 years below that of the general population.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    Harris & Barraclough review documented excess mortality among psychiatric patients, especially patients with schizophrenia.

    “A cornerstone study was the extensive review by Harris & Barraclough (1998), which documented excess mortality among psychiatric patients, especially patients with schizophrenia.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Harris & Barraclough (1998) source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Schizophrenia occurs worldwide.

    “schizophrenia occurs worldwide (McGrath et al. 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites McGrath et al. 2008 source

  • Probably not a substantial claim. It may state two separate claims as one.

    Study design and conductreasoning

    Some studies use only information on persons with schizophrenia who died, so results should be interpreted with caution.

    “However, some of the studies use only information on the persons with schizophrenia who died, and results should therefore be interpreted with caution.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    Cause-specific SMRs for schizophrenia were higher than 1 except for cerebrovascular disease, which was based on only three studies.

    “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.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Saha et al. 2007 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Interpretationreasoning

    The incidence of schizophrenia varies significantly across different groups within a population and between countries.

    “The overall picture is that the incidence of schizophrenia varies significantly not only across different groups within a population but also between countries.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Interpretationcitation

    Results from Denmark are similar to those of studies from other countries, although some differences are noted.

    “The results from Denmark are similar to those of studies from other countries, although some differences are noted.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Interpretationnone given

    More than 1% of a population has schizophrenia.

    “Although it is not a common disorder, more than 1% of a population has schizophrenia.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    Prognosis and outcome in persons with schizophrenia tended to be worse, including higher mortality rates, than in persons with bipolar disorder.

    “The prognosis and outcome in persons with schizophrenia tended to be worse (including higher mortality rates) than the outcome in persons with bipolar disorder (Shorter 1997).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Shorter 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Kraepelin's dichotomization proved later not to be entirely true because some patients with schizophrenia recovered completely.

    “Kraepelin's dichotomization proved later not to be entirely true because some patients with schizophrenia recovered completely”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Angst 2002 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Study design and conductreasoning

    Calculating excess mortality as differences in years lived compared to the general population presents advantages: it takes into account common causes of death with low excess mortality, gives more weight to deaths among younger persons, and presents a straightforward measure.

    “These advantages include that the method takes into account the effect of very common causes of death with relatively low excess mortality, it gives more weight to deaths occurring among younger persons (which are more common among persons with severe mental disorders than the general population), and it presents a straightforward and understandable measure of the magnitude of the excess mortality”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    More than 60 years ago, Odegard showed excess mortality in patients admitted to a Norwegian mental hospital from 1926 to 1941; mortality rate for men with schizophrenia was 3.2 times higher than the general Norwegian population, and for women 4.8.

    “The mortality rate for men with schizophrenia was 3.2 times higher than that for the general Norwegian population, and the corresponding number for women was 4.8.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Odegard (1951)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Persons living and/or born in the city have a higher incidence of schizophrenia.

    “persons living and/or born in the city have a higher incidence (Pedersen & Mortensen 2006)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Pedersen & Mortensen 2006 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    Males have a higher incidence of schizophrenia and an earlier onset than females.

    “males have a higher incidence of schizophrenia, males have an earlier onset (van der Werf et al. 2012)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites van der Werf et al. 2012

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Premisecitation

    Saha et al. 2007 systematic review of 37 studies found overall SMR 2.58, with 10% and 90% quantiles 1.18 and 5.76.

    “The overall SMR was 2.58, with 10% and 90% quantiles of 1.18 and 5.76, respectively.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Saha et al. 2007 source

  • It may state two separate claims as one.

    Premisecitation

    The cardiovascular mortality gap between persons with schizophrenia and the general population has grown; a Danish register-based study found MRR increased from around 2.0 in 1994 to 3.5 in 2006.

    “The cardiovascular mortality gap between persons with schizophrenia and the general population has also grown during the past few decades, according to a Danish register-based study (Laursen & Nordentoft 2011); the mortality rate ratio has increased from around 2.0 in 1994 to 3.5 in 2006 compared to the general population.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Laursen & Nordentoft 2011 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    The risk of suicide is approximately 13-fold higher for persons with schizophrenia compared to the general population.

    “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).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Saha et al. 2007 source

  • It may state two separate claims as one.

    Interpretationreasoning

    All studies find a significant and very low life expectancy in persons with schizophrenia.

    “In conclusion, all studies find a significant and very low life expectancy in persons with schizophrenia.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    Persons with schizophrenia are more vulnerable to chronic physical diseases; risk of medical disease is higher and prognosis is poorer.

    “Recently, it has been suggested that persons with schizophrenia are more vulnerable to chronic physical diseases; the risk of medical disease is higher, and the prognosis is poorer (Laursen et al. 2012).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Laursen et al. 2012 source

  • Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.

    Interpretationreasoning

    Lowering of somatic disorders must be a combined effort of all somatic specialties.

    “This is obviously just a mathematical thought experiment, but it nevertheless illustrates that the lowering of somatic disorders must be a combined effort of all somatic specialties.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    In a Danish study substituting rate of mortality from different causes in schizophrenia with rate from general population, results are not clear-cut because high mortality rates from cancer and heart disease 'eat' away expected beneficiary impact of lowering a specific mortality rate.

    “The results are not as clear-cut as expected because high mortality rates (from, e.g., cancer and heart disease)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Laursen 2011

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Premisecitation

    The Charlson index is twofold higher among persons with schizophrenia compared to the general population, suggesting increased occurrence of somatic disorders.

    “Furthermore, the paper showed that the Charlson index is twofold higher among persons with schizophrenia compared to the general population, which suggests there is an increased occurrence of somatic disorders in these individuals.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Laursen et al. 2011

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim. It may state two separate claims as one.

    Interpretationreasoning

    Although prevalence of some somatic disorders seems same or lower among schizophrenic patients, risk from early death caused by other somatic disorders or suicide and accidents should be kept in mind.

    “Although the prevalence of some somatic disorders (and causes of death) seems to be the same or even lower among schizophrenic patients, the risk from early death caused by other somatic disorders or suicide and accidents should be kept in mind.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    Physical illnesses in persons with schizophrenia are common but are diagnosed late and treated insufficiently.

    “Physical illnesses in persons with schizophrenia are common but are diagnosed late and treated insufficiently.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Laursen et al. 2012 source

  • It may state two separate claims as one.

    Premisecitation

    Antipsychotics, particularly atypical antipsychotics, have been associated with weight gain, dyslipidemia, diabetes, and other cardiac risk factors.

    “Antipsychotics, in particular atypical antipsychotics, have been associated with weight gain, dyslipidemia, diabetes, and other cardiac risk factors (Newcomer 2007).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Newcomer 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim.

    Interpretationcitation

    The association between schizophrenia and reduced rheumatoid arthritis could be explained by reduced tendency of patients with schizophrenia to report musculoskeletal pain.

    “The authors concluded that the association could be explained by the reduced tendency of patients with schizophrenia to report musculoskeletal pain (Mors et al. 1999).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Mors et al. 1999 source

  • It may state two separate claims as one.

    Interpretationcitation

    Although there is increased somatic comorbidity among persons with schizophrenia, mortality from natural causes is extremely high, suggesting excess mortality may be partly rooted in higher rates of somatic disorders and partly in underdetection or undertreatment of chronic disorders.

    “Although there is increased somatic comorbidity among persons with schizophrenia, the study also showed that mortality from natural causes is extremely high in patients with schizophrenia, and this suggests that the excess mortality may be partly rooted in higher rates of somatic disorders and partly in underdetection or undertreatment of chronic disorders (Laursen et al. 2011).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Laursen et al. 2011

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Premisecitation

    The risk of suicide and accidents among patients with schizophrenia is high.

    “The risk of suicide and accidents among patients with schizophrenia is high.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Laursen et al. 2012 source

  • It may state two separate claims as one.

    Interpretationcitation

    Different causes of mortality do not contribute equally or work independently.

    “In the same way, the different causes of mortality do not contribute equally or work independently.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    A Danish study found rates of invasive procedures were considerably lower and survival after first contact to hospital for heart disease was reduced in persons with schizophrenia compared to the general population.

    “A Danish study has found that the rates of invasive procedures were considerably lower and the survival after first contact to a hospital for heart disease was reduced in persons with schizophrenia compared to the general population (Laursen et al. 2009).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Laursen et al. 2009 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Interpretationnone given

    High mortality rates caused by other sources would lower the risk of getting a disease (or dying from it), especially if the disease has late onset.

    “High mortality rates caused by other sources would lower the risk of getting a disease (or dying from it), especially if the disease has a late onset, as is common with some cancers, for example.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    Persons with schizophrenia tend to have an unhealthy lifestyle (poor diet, smoking, excess alcohol consumption, and lack of exercise).

    “Persons with schizophrenia tend to have an unhealthy lifestyle (poor diet, smoking, excess alcohol consumption, and lack of exercise).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Laursen et al. 2012 source

  • It may state two separate claims as one.

    Premisecitation

    Patients with a psychiatric disorder tend to use medical services to a lesser degree, which could lead to increased mortality.

    “Furthermore, patients with a psychiatric disorder tend to use medical services to a lesser degree, which could lead to an increased mortality (Cradock-O' Leary et al. 2002).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Cradock-O' Leary et al. 2002 source

  • It may state two separate claims as one.

    Premisecitation

    Raedler 2010 concluded antipsychotics increased risk of metabolic syndrome, sudden cardiac death, and myocarditis/cardiomyopathy.

    “Raedler (2010) reviewed the effect of antipsychotic drugs and concluded that antipsychotics increased the risk of metabolic syndrome, sudden cardiac death, and myocarditis/cardiomyopathy.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Raedler 2010 source

  • It may state two separate claims as one.

    Premisecitation

    A Helsinki study found 0.37-fold use of antihypertensive drugs and 0.47-fold use of lipid-lowering drugs compared to the general population in schizophrenia.

    “A study from Helsinki (Lahti et al. 2012) found a 0.37-fold use of antihypertensive drugs and a 0.47-fold use of lipid-lowering drugs compared to the general population.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Lahti et al. 2012

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Interpretationreasoning

    Antipsychotic medication may cause adverse effects, which may negatively affect mortality, but it is unclear how different antipsychotic drugs may affect excess mortality.

    “Antipsychotic medication may cause adverse effects, which may negatively affect mortality, but it is unclear how different antipsychotic drugs may affect the excess mortality.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    Treatment with varenicline also increased the chance of smoking cessation, although the evidence is weaker than for bupropion.

    “Treatment with varenicline also increased the chance of smoking cessation, although the evidence is weaker than for bupropion (Williams et al. 2012).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Williams et al. 2012 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    In the general population in Denmark, smoking-related illnesses account for a reduction in life expectancy of 3.5 years for men and 3.0 years for women.

    “In the general population in Denmark, smoking-related illnesses account for a reduction in life expectancy of 3.5 years for men and 3.0 years for women ( Juel & Sørensen 2006).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Juel & Sørensen 2006

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Interpretationcitation

    A number of studies indicate that smoking is far more frequent among people with schizophrenia and contributes substantially to the reduced life expectancy in this patient group.

    “Even though we lack national statistics on smoking habits for people with schizophrenia, a number of studies indicate that smoking is far more frequent among people with schizophrenia and contributes substantially to the reduced life expectancy in this patient group.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Several investigators later concluded that Miles's estimates were most likely too high.

    “Several investigators later concluded that Miles's estimates were most likely too high for various reasons (Blair-West et al. 1997, 1999;Bostwick & Pankratz 2000;Inskip et al. 1998;Palmer et al. 2005).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Blair-West et al. 1997 source
    • cites Bostwick & Pankratz 2000 source
    • cites Inskip et al. 1998 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Weight gains resulting in a BMI of 30 or more occurred among 2.73% of these patients per year during the first three years of treatment.

    “Weight gains resulting in a BMI of 30 or more occurred among 2.73% of these patients per year during the first three years of treatment ( Jerrell et al. 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Jerrell et al. 2010 source

  • It may state two separate claims as one.

    Premisecitation

    A large randomized clinical trial of first-episode patients treated with different antipsychotic drugs found that all antipsychotic drugs were associated with a greater than 7% increase in weight during the trial; proportion of patients affected ranged from 37% (ziprasidone) to 86% (olanzapine).

    “A large randomized clinical trial of first-episode patients treated with different antipsychotic drugs (Kahn et al. 2008) found that all antipsychotic drugs were associated with a greater than 7% increase in weight during the trial; proportion of patients affected ranged from 37% (ziprasidone) to 86% (olanzapine).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kahn et al. 2008 source

  • It may state two separate claims as one.

    Interpretationreasoning

    The lifestyle interventions are not only effective but are also achievable for the participants.

    “This indicates that the lifestyle interventions are not only effective but are also achievable for the participants.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisenone given

    In addition to the effect on weight, significant changes have been linked with other clinically relevant somatic risk factors, including the levels of body fat percentage, fasting plasma glucose, and blood fat as well as waist measurement.

    “In addition to the effect on weight, significant changes have been linked with other clinically relevant somatic risk factors, including the levels of body fat percentage, fasting plasma glucose, and blood fat as well as waist measurement.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationcitation

    The excess risk of cardiovascular disease in CATIE patients was partly explained by higher frequency of cigarette smoking, although relative contributions of specific antipsychotic agents, diet, exercise, and quality of medical care remain to be clarified.

    “The excess risk was concluded to be partly explained by a higher frequency of cigarette smoking, although the relative contributions to cardiac risk of specific antipsychotic agents, diet, exercise, and quality of medical care remain to be clarified.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Goff et al. 2005 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    Miles (1977) estimated that 15% of persons with unipolar affective disorder, 15% with alcoholism, and 10% with schizophrenia would die from suicide.

    “One of the most cited papers is the review written by Miles (1977), which estimated that 15% of persons with unipolar affective disorder, 15% with alcoholism, and 10% with schizophrenia would die from suicide.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Miles 1977 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    The authors of the largest Dutch study concluded that the training could prevent VO2 max from declining.

    “The training was twice a week for six months, and the authors concluded that the training could prevent VO 2 max from declining.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Scheewe et al. 2012 source

  • It may state two separate claims as one.

    Interpretationreasoning

    Current evidence suggests that bupropion, varenicline, nicotine substitution, and smoking cessation programs are effective.

    “More studies on the efficacy of different smoking cessation methods are needed, but current evidence suggests that bupropion, varenicline, nicotine substitution, and smoking cessation programs are effective.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    Some evidence suggests that both bupropion and varenicline can increase the chances of quitting smoking among people with schizophrenia.

    “Several studies have investigated factors affecting the success of smoking cessation among people with schizophrenia, and some evidence suggests that both bupropion and varenicline can increase the chances of quitting smoking.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    Several studies have indicated that dietary habits are partly responsible for weight gain in schizophrenia, but medication can also independently cause weight gain.

    “Several studies have indicated that dietary habits are partly responsible for weight gain in schizophrenia, but medication can also independently cause weight gain.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Study design and conductnone given

    Miles's review was based on rather small studies with selected samples and brief follow-up periods.

    “However, this review was based on rather small studies with selected samples and brief follow-up periods.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Miles 1977 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Interpretationreasoning

    There is a lack of studies on long-term outcomes in persons using antipsychotic drugs, which impedes establishment of clear guidelines in use of drugs.

    “We have included only a few of the most recent papers to illustrate the lack of studies on long-term outcomes in persons using antipsychotic drugs, which impedes the establishment of clear guidelines in the use of the drugs.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Interpretationreasoning

    These estimates are lower than reported in the most cited papers in the field, but the figures are still substantial.

    “These estimates are lower than reported in the most cited papers in the field, but the figures are still substantial and emphasize the continuous need for prevention of suicide among people with schizophrenia.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Palmer and colleagues (2005) estimated the lifetime risk to be 5.6% for schizophrenia.

    “Inskip et al. (1998) estimated the lifetime risk to be 6% for affective disorder, 7% for alcohol dependence, and 4% for schizophrenia, whereas Palmer and colleagues (2005) estimated the lifetime risk to be 5.6% for schizophrenia.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Palmer et al. 2005 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Premisenone given

    No solid epidemiological studies to date have tested to which extent any or all of the above-mentioned factors can explain the excess mortality in schizophrenia.

    “However, it is worth noting that no solid epidemiological studies to date have tested to which extent any or all of the above-mentioned factors can explain the excess mortality in schizophrenia.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Interpretationreasoning

    The major sources of excess mortality have changed over the past 70 years.

    “However, the major sources of excess mortality have changed over the past 70 years.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    The lifestyle of people with mental illness can be changed, and to a great extent these individuals also want this change.

    “The lifestyle of people with mental illness can be changed, and to a great extent these individuals also want this change.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.

    Premisenone given

    Schizophrenia has a very strong impact on income, educational attainment, marital status, and other indicators associated with health and mortality.

    “Furthermore, schizophrenia has a very strong impact on income, educational attainment, marital status, and other indicators associated with health and mortality.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Premisenone given

    Lifestyle factors such as excess alcohol consumption and tobacco use and little attention to a healthy diet are more prevalent in psychiatric patients.

    “Second, lifestyle factors such as excess alcohol consumption and tobacco use and little attention to a healthy diet are more prevalent in psychiatric patients.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim.

    Interpretationreasoning

    People suffering from mental illness encounter a number of barriers to lifestyle changes, including illness symptoms, adverse drug effects, and life situations.

    “People suffering from mental illness encounter a number of barriers to lifestyle changes, including illness symptoms, adverse drug effects, and life situations.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisenone given

    The effect of nicotine substitution on persons with depression is the same as that on smokers without depression, corresponding to a cessation success rate of 14% to 22% after a six-month smoking cessation intervention.

    “The effect of nicotine substitution on persons with depression is the same as that on smokers without depression, corresponding to a cessation success rate of 14% to 22% after a six-month smoking cessation intervention.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.

    Premisenone given

    It has proven difficult to recruit people with bipolar disorders and ongoing depression for smoking cessation interventions, and only a very limited number of studies focus on long-term maintenance of achieved smoking cessation.

    “In general, it has proven difficult to recruit people with bipolar disorders and ongoing depression for smoking cessation interventions, and only a very limited number of studies focus on long-term maintenance of achieved smoking cessation.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisenone given

    Weak evidence also indicates that payment for participation in a smoking cessation program has a positive effect, but it is uncertain whether this also applies to the long term.

    “Weak evidence also indicates that payment for participation in a smoking cessation program has a positive effect, but it is uncertain whether this also applies to the long term.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisenone given

    The literature indicates that people with schizophrenia tolerate varenicline, which can increase the chance of smoking cessation, at least in the short term.

    “The effect of varenicline is not as clear, but the literature indicates that people with schizophrenia tolerate it, which can increase the chance of smoking cessation, at least in the short term.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may state two separate claims as one.

    Interpretationnone given

    Mounting evidence suggests that people suffering from schizophrenia have increased morbidity and mortality.

    “Mounting evidence suggests that people suffering from schizophrenia have increased morbidity and mortality.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    Excess death following hospitalization for a mental disorder indicates that a current mental disorder is a risk factor contributing to death from a physical disorder, and that the health system fails to prevent, identify, and treat physical diseases during hospitalization for a mental disorder.

    “Excess death following hospitalization for a mental disorder indicates not only that a current mental disorder is a risk factor contributing to death from a physical disorder, but also that the health system fails to prevent, identify, and treat physical diseases during hospitalization for a mental disorder.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisenone given

    Evidence of the effect of bupropion and other antidepressant drugs to promote smoking cessation is not as clear but findings indicate a slightly higher tendency of smoking cessation among people with depression who took these drugs.

    “Evidence of the effect of bupropion and other antidepressant drugs to promote smoking cessation is not as clear but findings indicate a slightly higher tendency of smoking cessation among people with depression who took these drugs.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given

    A significant share of this excess mortality, which shortens life by 15 to 20 years, is caused by somatic illness linked with an unhealthy lifestyle.

    “We also know that a significant share of this excess mortality, which shortens life by 15 to 20 years, is caused by somatic illness linked with an unhealthy lifestyle.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.

    Interpretationnone given

    Difficulties in diagnosing somatic comorbidities, undertreatment of diagnosed disorders, or even untoward effects of the treatment of schizophrenia (e.g., diabetes, obesity) are likely to contribute to excess mortality.

    “First, difficulties in diagnosing somatic comorbidities, undertreatment of diagnosed disorders, or even untoward effects of the treatment of schizophrenia (e.g., diabetes, obesity) are likely to contribute and could suggest possible avenues for prevention.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.

    Premisenone given

    Although excess mortality, and to some extent excess physical morbidity, has been amply documented, only a few studies have documented the causes of this excess mortality.

    “Although excess mortality, and to some extent excess physical morbidity, has been amply documented, only a few studies have documented the causes of this excess mortality.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisenone given

    Moderate evidence indicates that nicotine substitution treatment increases cessation of smoking among people with previous or ongoing depression.

    “Moderate evidence indicates that nicotine substitution treatment increases cessation of smoking among people with previous or ongoing depression.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisenone given

    In the case of people with schizophrenia, moderate evidence suggests that bupropion can nearly triple the chance of smoking cessation after six months, with no negative effects on psychotic symptoms.

    “In the case of people with schizophrenia, moderate evidence suggests that bupropion can nearly triple the chance of smoking cessation after six months, with no negative effects on psychotic symptoms.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    Inskip et al. (1998) estimated the lifetime risk to be 6% for affective disorder, 7% for alcohol dependence, and 4% for schizophrenia.

    “Inskip et al. (1998) estimated the lifetime risk to be 6% for affective disorder, 7% for alcohol dependence, and 4% for schizophrenia, whereas Palmer and colleagues (2005) estimated the lifetime risk to be 5.6% for schizophrenia.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Inskip et al. 1998 source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Premisenone given

    A number of studies indicate that health care employees with negative attitudes may actually form a barrier for lifestyle changes among people with mental illness.

    “A number of studies indicate that health care employees with negative attitudes may actually form a barrier for lifestyle changes among people with mental illness.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    This indicates that study participants are able to carry out the lifestyle interventions and that the interventions are effective.

    “This indicates that study participants are able to carry out the lifestyle interventions and that the interventions are effective.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisenone given

    Outcomes are not known for nonmotivated psychiatric patients in lifestyle interventions that focus on diet.

    “Outcomes are not known for nonmotivated psychiatric patients in lifestyle interventions that focus on diet.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Interpretationreasoning

    The lifestyles of the mentally ill are generally influenced by a number of dilemmas and conflicting feelings, and this implies that good intentions for a healthier lifestyle may not always result in taking action.

    “The lifestyles of the mentally ill are generally influenced by a number of dilemmas and conflicting feelings, and this implies that good intentions for a healthier lifestyle may not always result in taking action.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Premisenone given

    The concept of schizophrenia was originally defined to include patients with especially poor outcomes.

    “The concept of schizophrenia was originally defined to include patients with especially poor outcomes.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    The mortality gap not only persists but may actually even be increasing.

    “Thus, the mortality gap not only persists but may actually even be increasing.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationnone given

    This group of patients still has an exceptionally short life expectancy because of very high mortality in all age groups.

    “This group of patients still has an exceptionally short life expectancy because of very high mortality in all age groups.”
    Quote in the paperNot a substantial claim
105 of 105

  • The authors state this as an assumption.

    No mortality occurs in the age group 0-15 years old.

    “Note that we have assumed no mortality in the age group 0-15 years old.”
1 of 1

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?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • A study is described as randomized but cited as observational

    Minor

    The text calls the 18,154-patient comparison a randomized trial, while the cited reference identifies it as an observational study.

1 of 1

Citations

Cites

Flagged first, then by citations

1 of the 132 references couldn’t be matched to a known paper.

Research works printed but not linked: 11

  1. Alstrøm CH, 1942, Mortality in Mental Hospitals
  2. Cent. Prev. Board Health, 2006, Fysisk aktivitet i psykiatrien—undervisningsmateriale. [Physical activity in psychiatry—educational material.]
  3. Mitchell AJ, 2010, J. Psychol. Pharmacol., 24, 69
  4. Moller HJ, 2003, J. Clin. Psychiatry, 64, 23
  5. Newcomer JW, 2007, J. Clin. Psychiatry, 68, 8
  6. Nordentoft M, 2012, Psykisk Sygdom og ændringer i Livsstil. [Psychiatric Disease and Lifestyle Changes.]
  7. Odegard O, 1951, Acta Gen. Stat. Med., 2, 141
  8. Pedersen CB, 2006, Dan. Med. Bull., 53, 441
  9. Pedersen PV, 2012, SUSY Udsat 2012. Sundhedsprofil for social udsatte i Danmark 2012 og udviklingen siden 2007. [SUSY Exposed 2012. Health profile for socially vulnerable groups in Denmark 2012 and developments since 2007.]
  10. Prochaska JO, 1992, Prog. Behav. Modif., 28, 183
  11. Tsoi DT, 2013, Cochrane Database Syst. Rev., 2, CD007253

Cited by

Sorted by citations

Related

Metadata

Authors
Laursen, T. M., Nordentoft, M., & Mortensen, P. B.
Affiliations
  • Aarhus University (DK)
  • University of Copenhagen (DK)
ORCID
Venue
Annual Review of Clinical Psychology
Publisher
Annual Reviews
Published
2014-03-28
Volume
10
Issue
1
Pages
425-448
ISSN
  • 1548-5943 (ISSN-L)
  • 1548-5951
DOI
10.1146/annurev-clinpsy-032813-153657
OpenAlex
W2167532647
Cited by
913
References
132
Citations by year
2026: 67 · 2025: 93 · 2024: 100 · 2023: 107 · 2022: 102 · 2021: 100 · 2020: 89 · 2019: 65 · 2018: 52 · 2017: 47 · 2016: 45 · 2015: 27 · 2014: 16
FWCI
4.00
Type
journal article
Language
en
Open access
Locations
  • Annual Review of Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
Funders
  • Lundbeckfonden (R155-2014-1724, R155-2012-11280)
  • H. Lundbeck A/S
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
schizophrenia, excess mortality, life expectancy, mortality gap, modifiable risk factors, antipsychotic adverse effects, somatic comorbidity, lifestyle factors, mortality prevention
MeSH terms
Accidents, Alcohol Drinking, Humans, Life Expectancy, Life Style, Mortality, Obesity, Risk Factors, Schizophrenia, Smoking, Suicide, Antipsychotic Agents, Comorbidity, Metabolic Syndrome, Health Status Disparities

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.

A language model drew the claims from the paper on 2026-10-11, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-11 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Cited sources are checked with a language model’s help (gpt-6-sol).

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