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Mortality in schizophrenia and other psychoses: a 10-year follow-up of the ӔSOP first episode cohort

Reininghaus, U; Dutta, R; Dazzan, P; Doody, GA; Fearon, P; Lappin, J; Heslin, M; ... Jones, PB; + view all (2014) Mortality in schizophrenia and other psychoses: a 10-year follow-up of the ӔSOP first episode cohort. Schizophrenia Bulletin , 41 (3) pp. 664-673. 10.1093/schbul/sbu138. Green open access

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Abstract

The excess mortality in people with psychotic disorders is a major public health concern, but little is known about the clinical and social risk factors which may predict this health inequality and help inform preventative strategies. We aimed to investigate mortality in a large epidemiologically characterised cohort of individuals with first episode psychosis compared with the general population and to determine clinical and social risk factors for premature death. All 557 individuals with first episode psychosis initially identified in two areas (Southeast London and Nottinghamshire, UK) were traced over a 10-year period in the ӔSOP-10 study. Compared with the general population, all-cause (SMR 3.6, 95% CI 2.6-4.9), natural-cause (SMR 1.7, 95% CI 1.0-2.7) and unnatural-cause (SMR 13.3, 95% CI 8.7-20.4) mortality was very high. Illicit drug use was associated with an increased risk of all-cause mortality (adj. RR 2.31, 95% CI 1.06-5.03). Risk of natural-cause mortality increased with a longer time to first remission (adj. RR 6.61, 95% CI 1.33-32.77). Family involvement at first contact strongly reduced risk of unnatural-cause mortality (adj. RR 0.09, 95% CI 0.01-0.69). Our findings suggest that the mortality gap in people with psychotic disorders remains huge and may be wider for unnatural-cause mortality than previously reported. Efforts should now focus on further understanding and targeting these tractable clinical and social risk factors of excess mortality. Early intervention and dual diagnosis services may play a key role in achieving more rapid remission and carer involvement and addressing substance use problems to reduce excess mortality in psychosis.

Type: Article
Title: Mortality in schizophrenia and other psychoses: a 10-year follow-up of the ӔSOP first episode cohort
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/schbul/sbu138
Publisher version: http://dx.doi.org/10.1093/schbul/sbu138
Language: English
Additional information: © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/1443478
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