Antipsychotics and risk of natural death in patients with schizophrenia
Yayun Chen,1,2 Xiao Yang,1,2 Xiaorong Qin,3 Qin Yang,3 Huanhuan Fan,1,2 Jun Li,4 Xiuli Song,1,2 Shuang Xu,4 Wanjun Guo,1,2 Wei Deng,1,2 Qiang Wang,1,2 Tao Li,1,2 Xiaohong Ma1,21Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People&rs...
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Dove Medical Press
2019
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oai:doaj.org-article:69f9042ed3cb443da51037a455b756fb2021-12-02T03:08:22ZAntipsychotics and risk of natural death in patients with schizophrenia1178-2021https://doaj.org/article/69f9042ed3cb443da51037a455b756fb2019-07-01T00:00:00Zhttps://www.dovepress.com/antipsychotics-and-risk-of-natural-death-in-patients-with-schizophreni-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Yayun Chen,1,2 Xiao Yang,1,2 Xiaorong Qin,3 Qin Yang,3 Huanhuan Fan,1,2 Jun Li,4 Xiuli Song,1,2 Shuang Xu,4 Wanjun Guo,1,2 Wei Deng,1,2 Qiang Wang,1,2 Tao Li,1,2 Xiaohong Ma1,21Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 3Community Mental Health Prevention Department, The Severe Mental Health Disorder System of Chengdu, Chengdu, Sichuan, People’s Republic of China; 4Department of Geriatric Psychiatry, Sichuan Province Recover Veterans Hospital, Chongzhou, Sichuan, People’s Republic of ChinaBackground: Research on antipsychotics and early mortality in schizophrenia has arisen from Western countries and results show that mortality from natural causes is obviously increased in schizophrenia. China, differs largely from Western countries in health and social welfare systems, and Asian patients are more susceptible to side-effects and might require less antipsychotics than their Western counterparts. We, therefore, investigated the association between antipsychotic use and increased mortality from natural causes among patients with schizophrenia in China.Methods: We conducted a population-based nested case–control study using patients’ hardcopy archives obtained from the Severe Mental Health Disorder Systems of Chengdu between January 1, 2006 and December 31, 2013. We identified all schizophrenic patients aged 18–65 years who died of natural causes in 2013 (N=157), and their age- and gender-matched controls (N=444).Results: Antipsychotic use was more frequent in controls than in cases (59.9% vs 32.5%). Risk of death decreased significantly in those receiving antipsychotic monotherapy (adjusted odds ratio=0.27, 95% CI=0.16–0.46) and antipsychotic polypharmacy (adjusted odds ratio=0.29, 95% CI=0.12–0.70) than antipsychotic-free patients. Compared with monotherapy, antipsychotic-free treatment was associated with prominently increased mortality (adjusted odds ratio=3.64, 95% CI=2.18–6.08). When stratified by age and gender, the results remained unchanged.Conclusion: Antipsychotic monotherapy significantly decreased mortality from natural causes in schizophrenic patients while antipsychotic polypharmacy did not contribute to the excess mortality and deserves further clarification. We need to improve the physical health of schizophrenic patients and promote health education among community mental health staff and primary caregivers.Keywords: antipsychotics, polypharmacy, mortality, odds ratio, schizophreniaChen YYang XQin XYang QFan HLi JSong XXu SGuo WDeng WWang QLi TMa XDove Medical Pressarticleantipsychoticspolypharmacymortalityodds ratioschizophreniaNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 1863-1871 (2019) |
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antipsychotics polypharmacy mortality odds ratio schizophrenia Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 |
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antipsychotics polypharmacy mortality odds ratio schizophrenia Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Chen Y Yang X Qin X Yang Q Fan H Li J Song X Xu S Guo W Deng W Wang Q Li T Ma X Antipsychotics and risk of natural death in patients with schizophrenia |
| description |
Yayun Chen,1,2 Xiao Yang,1,2 Xiaorong Qin,3 Qin Yang,3 Huanhuan Fan,1,2 Jun Li,4 Xiuli Song,1,2 Shuang Xu,4 Wanjun Guo,1,2 Wei Deng,1,2 Qiang Wang,1,2 Tao Li,1,2 Xiaohong Ma1,21Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 3Community Mental Health Prevention Department, The Severe Mental Health Disorder System of Chengdu, Chengdu, Sichuan, People’s Republic of China; 4Department of Geriatric Psychiatry, Sichuan Province Recover Veterans Hospital, Chongzhou, Sichuan, People’s Republic of ChinaBackground: Research on antipsychotics and early mortality in schizophrenia has arisen from Western countries and results show that mortality from natural causes is obviously increased in schizophrenia. China, differs largely from Western countries in health and social welfare systems, and Asian patients are more susceptible to side-effects and might require less antipsychotics than their Western counterparts. We, therefore, investigated the association between antipsychotic use and increased mortality from natural causes among patients with schizophrenia in China.Methods: We conducted a population-based nested case–control study using patients’ hardcopy archives obtained from the Severe Mental Health Disorder Systems of Chengdu between January 1, 2006 and December 31, 2013. We identified all schizophrenic patients aged 18–65 years who died of natural causes in 2013 (N=157), and their age- and gender-matched controls (N=444).Results: Antipsychotic use was more frequent in controls than in cases (59.9% vs 32.5%). Risk of death decreased significantly in those receiving antipsychotic monotherapy (adjusted odds ratio=0.27, 95% CI=0.16–0.46) and antipsychotic polypharmacy (adjusted odds ratio=0.29, 95% CI=0.12–0.70) than antipsychotic-free patients. Compared with monotherapy, antipsychotic-free treatment was associated with prominently increased mortality (adjusted odds ratio=3.64, 95% CI=2.18–6.08). When stratified by age and gender, the results remained unchanged.Conclusion: Antipsychotic monotherapy significantly decreased mortality from natural causes in schizophrenic patients while antipsychotic polypharmacy did not contribute to the excess mortality and deserves further clarification. We need to improve the physical health of schizophrenic patients and promote health education among community mental health staff and primary caregivers.Keywords: antipsychotics, polypharmacy, mortality, odds ratio, schizophrenia |
| format |
article |
| author |
Chen Y Yang X Qin X Yang Q Fan H Li J Song X Xu S Guo W Deng W Wang Q Li T Ma X |
| author_facet |
Chen Y Yang X Qin X Yang Q Fan H Li J Song X Xu S Guo W Deng W Wang Q Li T Ma X |
| author_sort |
Chen Y |
| title |
Antipsychotics and risk of natural death in patients with schizophrenia |
| title_short |
Antipsychotics and risk of natural death in patients with schizophrenia |
| title_full |
Antipsychotics and risk of natural death in patients with schizophrenia |
| title_fullStr |
Antipsychotics and risk of natural death in patients with schizophrenia |
| title_full_unstemmed |
Antipsychotics and risk of natural death in patients with schizophrenia |
| title_sort |
antipsychotics and risk of natural death in patients with schizophrenia |
| publisher |
Dove Medical Press |
| publishDate |
2019 |
| url |
https://doaj.org/article/69f9042ed3cb443da51037a455b756fb |
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