Mortality in schizophrenia

Aside from the obvious setbacks caused by its hallmark symptoms, schizophrenia is hazardous to the health and safety of those who have the disease.

Life expectancy for those with schizophrenia is estimated to be as much as 20 percent lower than that of the general population. Most may not be aware, but mortality rates from a wide range of causes are much higher than average among schizophrenics.

Individuals with schizophrenia are more likely than normal to die from problems with their circulatory, digestive, endocrine, nervous or respiratory systems. Smoking related fatality is also especially prominent in those with schizophrenia.

I have already written of the increased risk of metabolic syndrome in those with schizophrenia. Half of all people with schizophrenia also have hypertension and three quarters have abdominal obesity – all things that can shorten the life-span.

Suicide rates are 10 to 20 times higher among schizophrenic individuals than in the general population and undetermined death is also more likely in this group. A recent study examining this particular statistic in Wales found the suicide rate in this population also seems to be on the rise – it is 20 times higher today than it was during the period of 1875 to 1924.

Not only are fatality rates higher for health and suicide reasons, but danger due to violence is another big problem for those with this disease.

Between 16 and 25 percent of individuals diagnosed with schizophrenia are reported to be victims of violence at some point in their lives.

I believe the widespread move of seriously ill individuals from hospitals into the community has resulted in a relative increase of cardiovascular and unnatural deaths in the schizophrenic population.

A large part of this problem is due to poverty and homelessness that often result when people who are unable to properly care for themselves are simply left to their own devices without sufficient supervision or health care.

In Scotland, a follow-up study of patients discharged from psychiatric wards between 1977 and 1994 found almost 30 percent had died by the end of the follow-up period – 732 more deaths than expected.

These kinds of statistics can be found most places with similar policies in mental health care.

Increasing numbers of our homeless suffer from psychotic illness and the death rate among homeless people is much higher than that of the general population.

All of this raises questions about the value we as a society really place on the independence of those with severe mental illness.

Are we truly taking an individual’s best interest to heart when we turn him out on the street? Should we consider homelessness and personal neglect a free choice made by people with this disease? Or do these things result from neglect and negligence on the part of the powers that be?

I don’t believe the current system is the solution.

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About the Author

Paul Latimer has over 25 years experience in clinical practice, research, and administration.

After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar.

Since 1983 he has been practicing psychiatry in Kelowna, BC, where he has held many administrative positions and conducted numerous clinical trials.

He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders.

He is an avid photographer, skier and outdoorsman.

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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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