A critical review of major mortality risk factors for all-cause mortality in first-episode schizophrenia: clinical and research implications
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A bibliographical search was performed to identify and evaluate the impact in first-episode schizophrenia of the major mortality risk factors as described by the World Health Organisation (2009). We found that at first diagnosis rates of diabetes were only slightly increased, although lipid abnormalities, mild hypertension and being overweight were commonly reported. Levels of drug and alcohol abuse were high, as were pre-diagnosis rates of smoking, physical inactivity and poor cardiorespiratory fitness. During the first year of antipsychotic treatment, there were significant increases in the rates of hyperglycaemia/diabetes, obesity, lipid abnormalities and hypertension, but no changes in fitness levels, smoking or drug and alcohol abuse. In chronic schizophrenia, excess cancer and cardiac deaths seem linked in part to availability and quality of care. Innate risk factors such as abnormal reelin and raised prolactin may also be important. New evidence, such as an inverse relationship between body mass index and suicide in the general population, suggests accepted wisdom may not apply to patients at high risk of ending their own lives. With current knowledge emphasis needs to be placed by early intervention services on physical fitness, smoking and other substance misuse, diabetes and hypertension, as well as focusing on weight reduction only in the obese.
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People with schizophrenia and other psychotic disorders die earlier than their peers in the general population, by around 15-20 years according to recent estimates.
“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 [1]
Consistent evidence has accrued that people with psychotic disorder have higher mortality rates than the general population.
“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 [1]
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Hjorthøj, C., Stürup, A. E., McGrath, J. J., & Nordentoft, M. (2017) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30078-0 · Cited by 1,304 · see citing works
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“Overweight and particularly obesity predicts cardiovascular risk, metabolic syndrome (MS) and diabetes mellitus type 2 (DM-II) [1–5] as well as an increased risk for cancer [6,7].”
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Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort
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Ringen, P. A., Falk, R. S., Antonsen, B., Faerden, A., Mamen, A., Rognli, E. B., Solberg, D. K., Martinsen, E. W., & Andreassen, O. A. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1832-6 · Cited by 17 · see citing works
- Authors
- Beary, M., Hodgson, R., & Wildgust, H. J.
- Affiliations
- Priory Hospital North London, London, UK
- Lyme Brook Centre, Stoke on Trent, UK
- Hiram Consulting Ltd, Ackworth, UK
- ORCID
- Hodgson, Richard
- Venue
- Journal of Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2012-03-30
- Volume
- 26
- Issue
- 5_suppl
- Pages
- 52-61
- ISSN
- 0269-8811 (ISSN-L)
- 1461-7285
- OpenAlex
- W2150344659
- Cited by
- 79
- References
- 134
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 9 · 2022: 1 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 4 · 2017: 15 · 2016: 2 · 2015: 4 · 2014: 16 · 2013: 9 · 2012: 1
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- first-episode schizophrenia, all-cause mortality, mortality risk factors, diabetes mellitus, hyperglycemia, obesity, lipid metabolism disorders, hypertension, physical inactivity, cardiorespiratory fitness, smoking, substance abuse, antipsychotic adverse effects, cancer mortality, cardiac mortality, reelin, prolactin, early intervention services
- MeSH terms
- Reelin Protein, Humans, Hypertension, Risk Factors, Schizophrenia, Overweight
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.
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