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Life expectancy and death by diseases of the circulatory system in patients with bipolar disorder or schizophrenia in the Nordic countries.

Open access
Laursen, Thomas Munk, Wahlbeck, Kristian, Hällgren, Jonas, Westman, Jeanette, Ösby, Urban, Alinaghizadeh, Hassan, Gissler, Mika, Nordentoft, Merete·2013·PLoS ONE
DOI 10.1371/journal.pone.0067133PMC PMC3691116
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Abstract

OBJECTIVE: Excess mortality from diseases and medical conditions (natural death) in persons with psychiatric disorders has been extensively reported. Even in the Nordic countries with well-developed welfare systems, register based studies find evidence of an excess mortality. In recent years, cardiac mortality and death by diseases of the circulatory system has seen a decline in all the Nordic countries, but a recent paper indicates that women and men in Denmark, Finland, and Sweden, who had been hospitalised for a psychotic disorder, had a two to three-fold increased risk of dying from a cardiovascular disease. The aim of this study was to compare the mortality by diseases of the circulatory system among patients with bipolar disorder or schizophrenia in the three Nordic countries Denmark, Sweden, and Finland. Furthermore, the aim was to examine and compare life expectancy among these patients. Cause specific Standardized Mortality Rates (SMRs) were calculated for each specific subgroup of mortality. Life expectancy was calculated using Wiesler's method. RESULTS: The SMR for bipolar disorder for diseases of the circulatory system was approximately 2 in all countries and both sexes. SMR was slightly higher for people with schizophrenia for both genders and in all countries, except for men in Denmark. Overall life expectancy was much lower among persons with bipolar disorder or schizophrenia, with life expectancy being from 11 to 20 years shorter. CONCLUSION: Our data show that persons in the Nordic countries with schizophrenia or bipolar disorder have a substantially reduced life expectancy. An evaluation of the reasons for these increased mortality rates should be prioritized when planning healthcare in the coming years.

AI snapshot

Written from the paper’s full text.

TL;DR

In Denmark, Finland, and Sweden, people hospitalized with bipolar disorder or schizophrenia had 2- to 3-fold overall mortality and substantially reduced life expectancy compared with the general population. Mortality from diseases of the circulatory system was about 2-fold elevated in bipolar disorder and somewhat higher in schizophrenia, except among men in Denmark.

Key findings

  • Among 39,375 persons with bipolar disorder and 66,088 with schizophrenia followed in 2000–2006, all-cause SMRs were 2.0–2.8 for bipolar disorder and 2.9–3.9 for schizophrenia; for example, men in Finland had SMR 2.8 for bipolar disorder and 3.3 for schizophrenia, while women in Finland had SMR 2.5 and 3.9, respectively.
  • SMRs for diseases of the circulatory system (DCS) in bipolar disorder were approximately 2 in all countries and both sexes, with overall DCS SMRs ranging from 1.7 to 2.2. In schizophrenia, overall DCS SMRs ranged from 1.8 to 2.9 and were higher than in bipolar disorder except for men in Denmark (1.8 vs 2.0).
  • Life expectancy at age 15 was 11 to 20 years shorter overall. In the table, differences for men were 12.7–19.8 years for bipolar disorder and 17.1–20.0 years for schizophrenia; for women, differences were 11.0–16.2 years for bipolar disorder and 15.6–16.9 years for schizophrenia.
  • During 2000–2006, 2,960 of 5,436 deaths (54%) in bipolar disorder and 6,424 of 9,535 deaths (67%) in schizophrenia would not have occurred if mortality matched the general population; 781 and 1,770 of these excess deaths were from DCS, and the total avoidable deaths across both groups were 9,384 over seven years.

Methods

  • Register-based cohort study in Denmark, Finland, and Sweden including all persons with a psychiatric hospitalization with a main diagnosis of bipolar disorder or schizophrenia. Follow-up began on 1 January 2000 or the 15th birthday, whichever came last, and ended on 1 January 2007 or death, whichever came first.
  • Diagnoses came from national psychiatric/hospital discharge registers using ICD-8, ICD-9, or ICD-10 as relevant; deaths came from national cause-of-death registers. Schizoaffective disorder was excluded from both diagnostic groups.
  • Cause-specific SMRs were age-standardized to the Nordic standard population in 2000 with 95% confidence intervals; life expectancy at 15 was calculated using Wiesler’s method with one-year age stratification; avoidable deaths were calculated as N*((SMR−1)/SMR).

Limitations

  • The paper states that schizoaffective disorder was excluded, that ICD diagnoses do not differentiate bipolar I from bipolar II disorder (so bipolar I may be overestimated), that antipsychotic treatment differences may partly explain cardiovascular mortality differences, and that Finland’s fragmented health care access may contribute to its higher SMRs.
  • Evident from the text: the cohort includes only patients with a psychiatric hospitalization, so findings may not generalize to non-hospitalized or outpatient-treated patients.
  • Evident from the text: register data lack individual confounders such as lifestyle, smoking, alcohol, exercise, and medication adherence; Swedish hospital data were incomplete before 1987, so case ascertainment relied on a 1987–1999 lookback.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1371/journal.pone.0067133

Cites

43 of 43 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 30 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The SMR for bipolar disorder for diseases of the circulatory system was lower than the all-cause SMRs.

    “The SMR for bipolar disorder for different subgroups of diseases of the circulatory system (DCS) was approximately 2 in all countries and both sexes, and thus lower than the all-cause SMRs, Table 1and 2.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The SMR for bipolar disorder for diseases of the circulatory system was approximately 2 in all countries and both sexes.

    “The SMR for bipolar disorder for diseases of the circulatory system was approximately 2 in all countries and both sexes.”
    • Also stated in: § Results · plain
      “The SMR for bipolar disorder for different subgroups of diseases of the circulatory system (DCS) was approximately 2 in all countries and both sexes, and thus lower than the all-cause SMRs, Table 1and 2.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In spite of recent focus on the excess mortality among persons with schizophrenia or bipolar disorder, persons with schizophrenia or bipolar disorder still have a substantially reduced life expectancy.

    “this study show that persons with schizophrenia or bipolar disorder still have a substantially reduced life expectancy.”
    Quote in the paperSubstantial claim
  • Findingown data

    Apart from the difference in SMRs, mortality rates and life expectancy are remarkably similar in the three countries.

    “Apart from this difference the mortality rates and life expectancy are remarkably similar in the three countries.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Persons with bipolar disorder in Denmark and Sweden had higher life expectancy than persons with schizophrenia.

    “Persons with bipolar disorder in Denmark and Sweden had higher life expectancy than persons with schizophrenia.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The probability of getting a diagnosis of schizophrenia or bipolar disorder before the age of 15 is virtually zero in the Nordic countries.
  • May combine two claims. 19
  • Classified as probably not a substantial claim. 17

  • May combine two claims.

    Findingreasoning

    Although men and women in Finland with bipolar disorder have lower overall mortality measured by SMR than men and women with schizophrenia, the potential loss of living years is larger among persons with bipolar disorder.

    “although men and women in Finland with bipolar disorder have a lower overall mortality measured by SMR than men and women with schizophrenia, the potential loss of living years are larger among persons with bipolar disorder.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    All-cause mortality SMR for men with schizophrenia was 3.3 in Finland, 3.0 in Denmark, and 2.9 in Sweden.

    “The SMRs for persons with schizophrenia, was even higher with a SMR for men equaling 3.3, 3.0 and 2.9 in Finland, Denmark, and Sweden, respectively, Table 1 and 2.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    During the years 2000 to 2006, the number of deaths in all three countries that would not have occurred if individuals with a psychiatric disorder had the same mortality as the general population was 2,960 (out of 5,436 deaths, 54%) in the group of persons with bipolar disorder and 6,424 (out of 9,535 deaths, 67%) in the group of schizophrenic persons.

    “During the years 2000 to 2006 the number of deaths in all three countries that would not have occurred in the hypothetical situation that the individuals with a psychiatric disorder had the same mortality as the general population was 2,960 (out of 5,436 deaths, 54%) in the group of persons with bipolar disorder and 6,424 (out of 9,535 deaths, 67%) in the group of schizophrenic persons.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: The mortality of the general population is an appropriate counterfactual for the mortality that patients with bipolar disorder or schizophrenia would have had in the absence of their psychiatric disorder.

  • May combine two claims.

    Findingown data

    All-cause mortality SMR for men with bipolar disorder was 2.8 in Finland, 2.2 in Denmark, and 2.0 in Sweden.

    “All-cause mortality was high among persons with bipolar disorder, resulting in a SMR for men in Finland equaling 2.8, in Denmark 2.2, and in Sweden 2.0.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    SMR for diseases of the circulatory system among persons with schizophrenia was lower than overall SMRs in Denmark and Finland, but not in Sweden.

    “SMR for DCS among persons with schizophrenia was also lower than overall SMRs in Denmark and Finland, but not in Sweden.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    All-cause mortality SMR for women with schizophrenia was 3.9 in Finland, 2.7 in Denmark, and 2.9 in Sweden.

    “For women with schizophrenia the SMR was 3.9, 2.7 and 2.9 in Finland, Denmark, and Sweden, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    All-cause mortality SMR for women with bipolar disorder was 2.5 in Finland, 2.3 in Sweden and 2.0 in Denmark.

    “The SMR for women was 2.5 in Finland, 2.3 in Sweden and 2.0 in Denmark.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In the Nordic countries, women and men with severe mental disorders have an approximately 15 and 20 years shorter life expectancy, respectively, than the general population.

    “In the Nordic countries, women and men with severe mental disorders have an approximately 15 and 20 years shorter life expectancy, respectively, than the general population [8].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Wahlbeck K, Westman J, Nordentoft M, Gissler M, Laursen TM (2011) Outcomes of Nordic mental health systems: life expectancy of patients with mental disorders. Br J Psychiatry. bjp.bp.110.085100 [pii];<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://dx.doi.org/10.1192/bjp.bp.110.085100" xlink:type="simple">10.1192/bjp.bp.110.085100</ext-link> [doi]. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    A study from Denmark showed that patients with bipolar affective disorder or schizophrenia still have an overall cardiac mortality that is higher than in the general population, and that the excess mortality tends to be even larger in the most recent calendar time period.

    “A study from Denmark showed that patients with bipolar affective disorder or schizophrenia still have an overall cardiac mortality that is higher than in the general population, and that the excess mortality tends to be even larger in the most recent calendar time period [12].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] TM Laursen, 2011, Heart disease treatment and mortality in schizophrenia and bipolar disorder - changes in the Danish population between 1994 and 2006, J Psychiatr Res source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Excess mortality from diseases and medical conditions in persons with psychiatric disorders has been extensively reported.

    “Excess mortality from diseases and medical conditions in persons with psychiatric disorders has been extensively reported [1].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] EC Harris, 1998, Excess mortality of mental disorder, Br J Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    The Swedish Cause of Death Register contains information about all deaths in Sweden and its coding error is estimated to be only 3%.

    “The Swedish Cause of Death Register contains information about all deaths in Sweden and the coding error is estimated from a sample of deaths and was only 3% [20].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] LA Johansson, 2000, Comparing Swedish hospital discharge records with death certificates: implications for mortality statistics, Int J Epidemiol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A recent paper indicates that women and men in Denmark, Finland, and Sweden, who had been hospitalised for a psychotic disorder, had a two to three-fold increased risk of dying from a cardiovascular disease.

    “a recent paper indicates that women and men in Denmark, Finland, and Sweden, who had been hospitalised for a psychotic disorder, had a two to three-fold increased risk of dying from a cardiovascular disease [11].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] M Nordentoft, 2013, Excess mortality, causes of death and life expectancy in 270,770 patients with recent onset of mental disorders in denmark, Finland and sweden, Plos One source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Diseases of the circulatory system are the most common cause of death in the general population in Western countries, including Denmark, Finland, and Sweden.

    “Diseases of the circulatory system are the most common cause of death in the general population in Western countries [9], [10], including Denmark, Finland, and Sweden.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [9] Laursen TM (2006) A register based epidemiological description of risk factors and outcomes for major psychiatric disorders, focusing on a comparison between bipolar affective disorder and schizophrenia. PhD thesis. Universty of Aarhus.

      Not checked in the free run.

    • cites [10] CH Hennekens, 2005, Schizophrenia and increased risks of cardiovascular disease, Am Heart J source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    The study included information from 20 million individuals from three Nordic countries with complete national coverage, and more than 100,000 persons with bipolar disorder or schizophrenia.

    “In a study including information from 20 million individuals from three Nordic countries with complete national coverage, and with more than 100,000 persons with bipolar disorder or schizophrenia”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The schizoaffective subgroup was not included in the analyses.

    “The schizoaffective subgroup, often included in the schizophrenia group, with a generally more favourable outcome than schizophrenia, was not included in our analyses.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Reviews have found a huge reduction in life expectancy of approximately 10 to 20 years in persons with schizophrenia.

    “Reviews have found a huge reduction in life expectancy of approximately 10 to 20 years in persons with schizophrenia.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    On average the excess mortality rate in people with schizophrenia resulted in an SMR equaling 2-3 and an SMR for persons with bipolar disorder equaling a little less than two.

    “On average the excess mortality rate in people with schizophrenia resulted in a SMR equaling 2–3 and a SMR for persons with bipolar disorder equaling a little less than two.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31]–[41]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The reductions of life expectancy among persons with bipolar disorder seem to be slightly smaller: approximately 10 years in a study from London, and 13 years in a Danish study made on data similar to the Danish data used in Table 3.

    “The reductions of life expectancy among persons with bipolar disorder seem to be slightly smaller: approximately 10 years in a study from London [43], and 13 years in a Danish study made on data similar to the Danish data used in Table 3 [44].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [43] CK Chang, 2011, Life expectancy at birth for people with serious mental illness and other major disorders from a secondary mental health care case register in London, PLoS One source

      Not checked in the free run.

    • cites [44] TM Laursen, 2011, Life expectancy among persons with schizophrenia or bipolar affective disorder, Schizophr Res source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The explanation for the paradox is that Finnish men with bipolar disorder have a very high mortality rate in the age groups between 15 and 44 years, so a person who dies at a young age contributes many years to the potential loss of living years.

    “the explanation is that e.g. Finnish men with bipolar disorder have a very high mortality rate in the age groups between 15 and 44 years: a person who dies at a young age contributes many years to the potential loss of living years, and thus this measure becomes high although SMRs are not that high.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The risk of suicide is very high in persons with schizophrenia or bipolar disorder.

    “And lastly, the risk of suicide is very high [40].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] TM Laursen, 2012, Life expectancy and cardiovascular mortality in persons with schizophrenia, Curr Opin Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Physical illnesses in persons with schizophrenia or bipolar disorder are apparently treated insufficiently or diagnosed too late.

    “physical illnesses in persons with schizophrenia or bipolar disorder are apparently treated insufficiently or diagnosed too late”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] TM Laursen, 2012, Life expectancy and cardiovascular mortality in persons with schizophrenia, Curr Opin Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    Persons with schizophrenia and bipolar disorder constitute a vulnerable group of patients who need special attention.

    “Persons with schizophrenia and bipolar disorder constitute a vulnerable group of patients who need special attention.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    This may create higher levels of health inequity in Finland than in Denmark or Sweden.

    “This may create higher levels of health inequity in Finland than in Denmark or Sweden.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Health care access in Finland is compromised by a fragmented health system more dependent on employment status and income than in Denmark and Sweden.

  • May combine two claims.

    Interpretationown data

    Although schizophrenia and bipolar disorder are rare disorders, the extent of the increased mortality is a substantial public health problem that has not been addressed.

    “it shows that although schizophrenia and bipolar disorder are rare disorders, the extent of the increased mortality is a substantial public health problem that has not been addressed.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Some antipsychotic medicine may have negative side effects, although no clear differences between different antipsychotics have been found.

    “some antipsychotic medicine may have negative side effects, although no clear differences between different antipsychotics have been found”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] TM Laursen, 2012, Life expectancy and cardiovascular mortality in persons with schizophrenia, Curr Opin Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Most studies find that cardiovascular disorder is the leading cause of death in both schizophrenia and bipolar disorder.

    “Most studies find that cardiovascular disorder is the leading cause of death in both disorders.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31]–[41]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The difference in SMRs may be related to problems in health care access in Finland.

    “The difference may be related to problems in health care access in Finland.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Health care access in Finland is compromised by a fragmented health system more dependent on employment status and income than in Denmark and Sweden.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Persons with schizophrenia and bipolar disorder tended to have an unhealthy lifestyle especially regarding diet, smoking, alcohol, and exercise.

    “persons with schizophrenia and bipolar disorder tended to have an unhealthy lifestyle especially regarding diet, smoking, alcohol, and exercise”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] TM Laursen, 2012, Life expectancy and cardiovascular mortality in persons with schizophrenia, Curr Opin Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a recent study from Stockholm County, around 30% of persons with bipolar disorder treated at a specialized affective disorder unit were medicated with antipsychotics, while in schizophrenia almost none would be without antipsychotics, and also taking larger doses.

    “In a recent study from Stockholm County, around 30% of persons with bipolar disorder treated at a specialized affective disorder unit medicated with antipsychotics [42], while in schizophrenia almost none would be without antipsychotics, and also taking larger doses.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [42] M Adler, 2012, Symptoms and treatment of bipolar patients in Sweden, Int J Psychiatry Clin Pract source

      Not checked in the free run.

29 of 29

  • The paper relies on this without support.

    The probability of getting a diagnosis of schizophrenia or bipolar disorder before the age of 15 is virtually zero in the Nordic countries.

    “The probability of getting a diagnosis of schizophrenia or bipolar disorder before the age of 15 is virtually zero in the Nordic countries, and thus the reason for starting follow-up at that time point in life.”

  • The authors state this as an assumption.

    The mortality of the general population is an appropriate counterfactual for the mortality that patients with bipolar disorder or schizophrenia would have had in the absence of their psychiatric disorder.

    “the hypothetical situation that the individuals with a psychiatric disorder had the same mortality as the general population”
    “By reducing mortality in the group of persons with schizophrenia or bipolar disorder (approximately 100,000 persons) to the level of the general population”

  • The paper relies on this without support.

    Health care access in Finland is compromised by a fragmented health system more dependent on employment status and income than in Denmark and Sweden.

    “in Finland availability is compromised by a fragmented health system, where health care access is more dependent on employment status and income level.”
3 of 3

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.

  • Swedish life expectancy is not higher for every patient group

    Minor

    The statement includes women with schizophrenia, but Table 3 gives them a remaining life expectancy of 50.7 years in Sweden versus 51.9 years in Finland.

  • Finnish men's all-cause SMR confidence intervals do not overlap

    Minor

    For Finnish men, the table gives an all-cause SMR interval of 2.5-3.0 for bipolar disorder and 3.2-3.5 for schizophrenia. These intervals do not overlap, contrary to the stated exception.

  • The stated DCS subgroups both include ICD code I20

    Minor

    The methods place I20 in both the ischaemic heart disease and miscellaneous DCS ranges, although these are presented as separate subgroups.

  • Finnish women's bipolar DCS deaths do not sum to the overall count

    Minor

    The listed Finnish women's bipolar-disorder DCS subgroups contain 8 ischaemic heart disease deaths, 33 cerebrovascular deaths, and 30 other DCS deaths: 71 in total, not 121. The ischaemic heart disease count of 8 is also smaller than its listed subset of 24 acute myocardial infarction deaths.

    Reported 121 · recomputed 71

  • Schizophrenia DCS SMRs are lower than all-cause SMRs in Sweden too

    Minor

    The paper says Sweden is an exception, yet Tables 1 and 2 report Swedish schizophrenia DCS SMRs of 2.5 for men and 2.6 for women, both below their respective all-cause SMRs of 2.9.

5 of 5

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. I Keskimäki, 1991, The accuracy of data on diagnoses, procedures and accidents in the Finnish Hospital Discharge Register, International Journal of Health Sciences, 2, 15
  2. Clayton D, Hills M (1993) Statistical models in epidemiology. Oxford University.
  3. Breslow NE, Day NE (1987) Rates and Rate standardization. In: Heseltine E, editors. Statistical methods in cancer research. Lyon: Oxford University press. 48–82.
  4. Wiesler H (1954) Une me’ thode simple pour la construction de tables de mortalite’ abre’ ge’ es. Proceedings of the First World Population Conference, Rome,vol 4 United Nations, 1954.

Cited by

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Related

Authors
Laursen, T. M., Wahlbeck, K., Hällgren, J., Westman, J., Ösby, U., Alinaghizadeh, H., Gissler, M., & Nordentoft, M.
Affiliations
  • Aarhus University (DK)
  • Finnish Institute for Health and Welfare (FI)
  • Karolinska Institutet (SE)
  • University of Copenhagen (DK)
Corresponding author
Laursen, Thomas Munk
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2013-06-24
Volume
8
Issue
6
Pages
e67133
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0067133
PMC
PMC3691116
OpenAlex
W2063598898
Semantic Scholar
6de46ba13d1d5cdb71f0637d20707d4c3c6bde53
Cited by
313
References
43
Citations by year
2026: 16 · 2025: 9 · 2024: 24 · 2023: 23 · 2022: 24 · 2021: 28 · 2020: 24 · 2019: 37 · 2018: 28 · 2017: 31 · 2016: 31 · 2015: 19 · 2014: 18 · 2013: 1
FWCI
16.00
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
Funders
  • Stanley Medical Research Institute
  • Lundbeckfonden (R155-2012-11280)
  • H. Lundbeck A/S
  • Medical Research Council (MR/K006525/1)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
bipolar disorder, schizophrenia, circulatory diseases, cardiovascular mortality, excess mortality, life expectancy, standardized mortality ratio, mental illness, Nordic countries, Denmark, Sweden, Finland
MeSH terms
Bipolar Disorder, Cardiovascular Diseases, Cardiovascular System, Cause of Death, Female, Humans, Life Expectancy, Male, Scandinavian and Nordic Countries, Schizophrenia

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