The DOI matches its Crossref record; 49 of the 50 references it cites were found in a registry or an index.
Comorbidities and Mortality in Persons With Schizophrenia: A Swedish National Cohort Study
Abstract
OBJECTIVE: Schizophrenia is associated with premature mortality, but the specific causes and pathways are unclear. The authors used outpatient and inpatient data for a national population to examine the association between schizophrenia and mortality and comorbidities. METHOD: This was a national cohort study of 6,097,834 Swedish adults, including 8,277 with schizophrenia, followed for 7 years (2003-2009) for mortality and comorbidities diagnosed in any outpatient or inpatient setting nationwide. RESULTS: On average, men with schizophrenia died 15 years earlier, and women 12 years earlier, than the rest of the population, and this was not accounted for by unnatural deaths. The leading causes were ischemic heart disease and cancer. Despite having twice as many health care system contacts, schizophrenia patients had no increased risk of nonfatal ischemic heart disease or cancer diagnoses, but they had an elevated mortality from ischemic heart disease (adjusted hazard ratio for women, 3.33 [95% CI=2.73-4.05]; for men, 2.20 [95% CI=1.83-2.65]) and cancer (adjusted hazard ratio for women, 1.71 [95% CI=1.38-2.10; for men, 1.44 [95% CI=1.15-1.80]). Among all people who died from ischemic heart disease or cancer, schizophrenia patients were less likely than others to have been diagnosed previously with these conditions (for ischemic heart disease, 26.3% compared with 43.7%; for cancer, 73.9% compared with 82.3%). The association between schizophrenia and mortality was stronger among women and the employed. Lack of antipsychotic treatment was also associated with elevated mortality. CONCLUSIONS: Schizophrenia patients had markedly premature mortality, and the leading causes were ischemic heart disease and cancer, which appeared to be underdiagnosed. Preventive interventions should prioritize primary health care tailored to this population, including more effective risk modification and screening for cardiovascular disease and cancer.
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In the citing paper
“cardiovascular disease emerges as the leading cause of premature mortality in individuals with SMI, as supported by substantial evidence [19–22].”
From A retrospective and comprehensive analysis of excess life-years lost, mortality risk, and cause of death among severe mental illness in China (2025) · cites this paper as [21]
In the citing paper
“The same method was used in a study from Sweden that found that persons with schizophrenia died 15 years (men) and 12 years (women) earlier than the general population (Crump et al. 2013).”
From Excess early mortality in schizophrenia. (2014) · cites this paper as Crump et al. 2013
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 [2]
In the citing paper
“Conflicting results have been recently reported as to whether illicit drug use contributes to excess mortality in psychosis.2,25,26”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [2]
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 [2]
In the citing paper
“overall, findings on the association between exposure to antipsychotic medication and natural-cause mortality remain inconsistent.2,48,49”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [2]
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 [2]
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Pellen, N., Gouzien, B., Troënes, M., Khelifi, S., Ragot, G., & Glaz, A. L. (2026) · European Journal of General Practice · doi:10.1080/13814788.2026.2619260 · Cited by 1
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Bohus, B., & Kegye, A. (2026) · Orvosi Hetilap · doi:10.1556/650.2026.33573 · Cited by 1
Sommerhoff, C., Bort, M., Prisco, M. D., Paolucci, S., Dalmases, M., Oliva, V., Vieta, E., Murru, A., & Fico, G. (2026) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.70119 · Cited by 1
The Immune and Metabolic Factors of Schizophrenia
Dev, K. K., & O’Connell, K. E. (2014) · Cited by 1
Antipsychotic-Related Mortality
Cohen, D. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-803376-0.00015-0 · Cited by 1
Klassifikation, Diagnostik und Differenzialdiagnostik (Modul 2)
Gäebel, W., Hasan, A., & Falkai, P. (2019) · Springer eBooks · doi:10.1007/978-3-662-59380-6_2 · Cited by 1
Medical Morbidity and Mortality
Freudenreich, O. (2019) · Current clinical psychiatry · doi:10.1007/978-3-030-29450-2_25 · Cited by 1
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Katz, R. T., & Katz, R. B. (2017) · AMA guides newsletter · doi:10.1001/amaguidesnewsletters.2017.novdec01 · Cited by 1
Ayub, M., Arsalan, A., Khan, S.-U.-D. A., Bajwa, S., Hussain, F., Umar, M., Khizar, B., Sibtain, M., Butt, A., Mukhtar-Ul-Haq, M., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-042331 · Cited by 1
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Roberts, R. J. (2021) · Springer eBooks · doi:10.1007/978-981-15-6631-8_42 · Cited by 1
Yamada, Y., Fujiwara, M., Etoh, T., Wada, R., Inoue, S., Mimaki, Y., Kodama, M., Yoshimura, Y., Horii, S., Matsushita, T., et al. (2023) · Psycho-Oncology · doi:10.1002/pon.6143 · Cited by 1
Casas, A. V., Diago, C. A. A., Calvo, J. A., Gómez‐Revuelta, M., Pinilla, P. S., Ovejas-Catalán, C., Pérez, P. F., Núñez, M. R., López, R. G., Ruiz, M. J., et al. (2023) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.sjpmh.2023.10.004 · Cited by 1
Shafi, D. E. S., Jørgensen, K. N., Bjella, T. D., Nesvåg, R., Dieset, I., Melle, I. S., Andreassen, O. A., & Jönsson, E. G. (2024) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2024.2305806 · Cited by 2
Sipilä, L. J., Tanskanen, T. J., Heikkinen, S. M. M., Seppä, K., Aavikko, M., Ravantti, J., Aaltonen, L. A., & Pitkäniemi, J. M. (2024) · Acta Oncologica · doi:10.2340/1651-226x.2024.40757 · Cited by 1
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Lugo, G. F. O., Gómez–Restrepo, C., Peñaranda, A. P. B., Valencia, J. G., Jaramillo, L. E., Tamayo, N., de Arenas, M. L. C. N., & Fernández, C. V. (2015) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2015.05.008 · Cited by 1
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Metadata
- Authors
- Crump, C., Winkleby, M. A., Sundquist, K., & Sundquist, J.
- Affiliations
- Lund University (SE)
- Venue
- American Journal of Psychiatry
- Published
- 2013-03
- Volume
- 170
- Issue
- 3
- Pages
- 324-333
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2157959378
- Cited by
- 619
- References
- 50
- Citations by year
- 2026: 20 · 2025: 28 · 2024: 49 · 2023: 58 · 2022: 47 · 2021: 51 · 2020: 58 · 2019: 63 · 2018: 40 · 2017: 59 · 2016: 40 · 2015: 39 · 2014: 46 · 2013: 20
- FWCI
- 34.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- National Institute on Drug Abuse (R01DA030005)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- schizophrenia, premature mortality, comorbidities, ischemic heart disease, cancer, sex differences, employment status, antipsychotic drugs, underdiagnosis, cardiovascular screening, cancer screening, primary care
- MeSH terms
- Adult, Aged, Aged, 80 and over, Ambulatory Care, Cause of Death, Female, Hospitalization, Humans, Life Expectancy, Male, Middle Aged, Neoplasms, Risk, Schizophrenia, Sweden, Cohort Studies, Comorbidity, Myocardial Ischemia, Young Adult
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