Review: Mortality in schizophrenia: a measurable clinical endpoint
Open accessAbstract
Over the last five years, large data sets on mortality in schizophrenia have been published which have established mortality as a measurable clinical endpoint. Four issues need clarification: whether mortality rates are declining, what the causes of death are, the effects antipsychotic treatments have on mortality and whether these data inform as to how mortality may be reduced in the future. A PubMed search was carried out to identify relevant publications. The search strategy was conducted as a review focusing predominantly on data since 2006. A large number of retrospective epidemiological and prospective studies have been published on mortality rates and causation in schizophrenia, predominantly from 2006—2009. Data suggest that the mortality gap with the general population increased from the 1970s but may have peaked in the mid-1990s. The main causes of mortality are suicide, cancer and cardiovascular disease, with evidence that cancer mortality rates are similar to cardiovascular mortality rates. Mortality causation is dependent upon age of the cohort, length of follow up and type of study. Antipsychotic treatments reduce mortality when compared with no treatment and atypical antipsychotics do not appear to increase cardiovascular mortality and morbidity compared with conventionals; further research is required for any definitive conclusion.
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Causes of death in schizophrenia primarily involve cardiovascular disease, cancer, and suicide.
“Mortality in schizophrenia has been increasingly recognized as a measurable clinical endpoint, with causes of death primarily involving cardiovascular disease, cancer, and suicide [2].”
From Trends in Sudden Death Among Schizophrenia Inpatients (2025) · cites this paper as [2]
The reliability of THIN for research purposes has been validated against experimental and other observational evidence.
“The reliability of THIN for research purposes has been validated against experimental and other observational evidence.41,42”
From Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014 (2017) · cites this paper as [42]
The Introduction says that the quality of retrospective epidemiological databases needs to be confirmed. The section on the role of databases discusses validation of Nordic death certificates, not THIN. Searches for THIN and for comparisons with experimental or other observational evidence found no passage addressing the claimed validation. (LLM, conf=0.73)
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References 61 · Cited by 185
- Authors
- Bushe, C. J., Taylor, M., & Haukka, J.
- Affiliations
- Eli Lilly (United Kingdom) (GB)
- NHS Lothian (GB)
- University of Helsinki (FI)
- Corresponding author
- Bushe, Chris J
- Venue
- Journal of Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2010-10-05
- Volume
- 24
- Issue
- 4_suppl
- Pages
- 17-25
- ISSN
- 0269-8811 (ISSN-L)
- 1461-7285
- PMC
- PMC2951589
- OpenAlex
- W2026268014
- Cited by
- 185
- References
- 61
- Citations by year
- 2025: 4 · 2024: 7 · 2023: 8 · 2022: 8 · 2021: 12 · 2020: 5 · 2019: 15 · 2018: 16 · 2017: 14 · 2016: 13 · 2015: 19 · 2014: 24 · 2013: 17 · 2012: 13
- FWCI
- 1.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychopharmacology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- 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, mortality, clinical trial endpoints, mortality gap, causes of death, suicide, cancer mortality, cardiovascular mortality, antipsychotic drugs, atypical antipsychotics, typical antipsychotics, cardiovascular risk
- MeSH terms
- Cardiovascular Diseases, Female, Humans, Male, Research Design, Schizophrenia, Suicide, Antipsychotic Agents, Databases, Factual, Treatment Outcome, Risk Reduction Behavior
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