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2014 ; 40
(4
): 796-803
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Mortality in schizophrenia: clinical and serological predictors
#MMPMID23943410
Dickerson F
; Stallings C
; Origoni A
; Schroeder J
; Khushalani S
; Yolken R
Schizophr Bull
2014[Jul]; 40
(4
): 796-803
PMID23943410
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Persons with schizophrenia have a reduced life expectancy largely due to death
from natural causes. Factors that have been previously associated with excess
mortality include cigarette smoking and antipsychotic medication. The role of
other environmental factors such as exposure to infectious agents has been the
subject of only limited investigation. We prospectively assessed a cohort of
persons with schizophrenia with a clinical evaluation and a blood sample from
which antibodies to human herpes viruses and Toxoplasma gondii were measured.
Mortality was determined with data from the National Death Index following a
period of up to 11 years. We examined the role of demographic, serological, and
clinical factors on mortality. A total of 25 (5%) of 517 persons died of natural
causes. The standardized mortality ratio was 2.80 (95% CI 0.89, 6.38). After
adjusting for age and gender, mortality from natural causes was predicted in
separate models by cigarette smoking (relative risk [RR] = 4.66, P = .0029);
lower cognitive score (RR = 0.96, P = .013); level of antibodies to Epstein-Barr
virus (RR = 1.22, P = .0041) and to Herpes Simplex virus type 1 (RR = 1.19, P =
.030); immunologic disease (RR = 3.14, P = .044); and genitourinary disease (RR =
2.70; P = .035). Because cigarette smoking confers an almost 5-fold risk of
mortality, smoking cessation is an urgent priority. Having an elevated level of
antibodies to Epstein-Barr virus and to Herpes Simplex virus type 1 are also
significant predictors of death from natural causes.
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