The influence of comorbid disease on premature death due to natural and unnatural causes in persons with schizophrenia
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Background: Comorbid disease may increase mortality in persons with schizophrenia, but how specific diseases are associated with natural and unnatural death in different age groups is unclear. Aims: To investigate the association between eight major comorbid diseases and death from natural and unnatural causes in different age groups in persons with schizophrenia. Method: Retrospective register-based cohort study in 77,794 persons with schizophrenia in Denmark, 1977–2015. Using Cox regression in matched cohorts, we estimated hazard ratios for natural and unnatural death in three age groups (<55 years, 55–64 years, ≥65 years). Results: Hypertensive disease, atrial fibrillation, coronary heart disease, cerebrovascular disease, heart failure, type 2 diabetes, liver disease and chronic kidney disease were all strongly associated with natural death, with the strongest associations observed in persons <55 years (hazard ratio [HR] range 1.98–7.19). The strongest associations were observed for heart failure (HR 7.19, 95 % confidence interval [CI] 5.57–9.28; HR 4.56, CI 3.85–5.40; HR 2.83, CI 2.53–3.17), liver disease (HR 4.66, CI 3.59–6.05; HR 4.70, CI 3.55–6.22; HR 2.57, CI 1.98–3.34) and chronic kidney disease (HR 6.59, CI 1.66–26.1; HR 7.37, CI 3.03–17.9; HR 2.86, CI 1.84–4.46) for persons <55 years, 55–64 years and ≥65 years, respectively. Liver disease was strongly associated with unnatural death in persons <55 years (HR 5.42, CI 3.01–9.75); associations with the remaining comorbidities were weaker. Conclusions: Comorbid disease was strongly associated with natural death, with the strength of the associations decreasing with age. Comorbid disease was also modestly associated with unnatural death, regardless of age.
Originalsprog | Engelsk |
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Tidsskrift | Schizophrenia Research |
Vol/bind | 257 |
Sider (fra-til) | 27-33 |
ISSN | 0920-9964 |
DOI | |
Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
This study was funded by the Lundbeck Foundation (Grant number R208-2015-3357 ). The Lundbeck Foundation had no influence on study design, data collection and analysis, or preparation of the manuscript.
Publisher Copyright:
© 2023 The Authors
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