Predictors of Mortality Following a Schizophrenia Spectrum Diagnosis: Evidence From the 20-Year Follow-up of the OPUS Randomized Controlled Trial

• Published in: Schizophrenia bulletin 2023-09, Vol.49 (5), p.1256-1268
• Main Authors: Starzer, Marie Stefanie Kejser, Hansen, Helene Gjervig, Hjorthøj, Carsten, Speyer, Helene, Albert, Nikolai, Nordentoft, Merete
• Format: Article
• Language: English
• Subjects: Cause of Death; Follow-Up Studies; Humans; Psychotic Disorders; Regular; Schizophrenia - epidemiology; Suicide
• ISSN: 0586-7614; 1745-1701; 1745-1701
• DOI: 10.1093/schbul/sbad111

Abstract Background and Hypothesis The life expectancy of patients diagnosed with schizophrenia is 10–12 years lower than in the general population and the mortality gap seems to be worsening. Many of these deaths might be avoidable. We aimed to determine mortality rates and causes of death after a first-episode psychosis, and to examine if clinical characteristics at baseline or during illness could predict mortality. Study Design The OPUS study was a randomized controlled trial of 578 patients first diagnosed with schizophrenia spectrum disorders. Patients were clinically assessed after 2, 5, 10, and 20 years. Information about time and cause of death was obtained from the Danish Cause of Death Register. Hazard ratios were used to assess predictors of death. Study Results In total, 82 (14.4%) participants died during 20 years of follow-up. The most common cause of death was suicide (27%). At baseline employment (HR 0.47 P = .049), psychotic disorder other than schizophrenia (HR 0.36, P = .017), and longer duration of untreated psychosis (HR 0.57 P = .042) predicted lower mortality while substance use predicted higher mortality (HR 2.56, P