Transformation of excess mortality in people with schizophrenia and bipolar disorder in Taiwan
Journal
Psychological Medicine
Journal Volume
47
Journal Issue
14
Pages
2483-2493
Date Issued
2017
Author(s)
Abstract
Background Given the concerns regarding the adverse health outcomes associated with weight gain and metabolic syndrome in relation to use of second-generation antipsychotics (SGAs), we aimed in this study to explore whether the increase in the use of SGAs would have any impacts on the trend of excess mortality in people with schizophrenia and bipolar disorder (BPD). Method Two nationwide samples of individuals with schizophrenia and BPD were identified in Taiwan's National Health Insurance Research Database in 2003 and in 2008, respectively. Age- and gender-standardized mortality ratios (SMRs) were calculated for each of the 3-year observation periods. The SMRs were compared between the calendar year cohorts, by disease group, and by causes of death. Results The mortality gap for people with schizophrenia decreased slightly, revealing an SMR of 3.40 (95% CI 3.30-3.50) for the 2003 cohort and 3.14 (3.06-3.23) for the 2008 cohort. The mortality gap for BPD individuals remained relatively stable with only those aged 15-44 years having an SMR rising significantly from 7.04 (6.38-7.76) to 9.10 (8.44-9.79). Additionally, in this group of BPD patients aged 15-44 years, the natural-cause-SMR increased from 5.65 (4.93-6.44) to 7.16 (6.46-7.91). Conclusions Compared with the general population, the gap in the excess mortality for people with schizophrenia reduced slightly. However, the over 200% difference between the cohorts in the excess mortality for BPD individuals aged 15-44 years could be a warning sign. Future research to further examine the related factors underlying those changes is warranted. Copyright ? Cambridge University Press 2017.
Subjects
Bipolar disorder; excess mortality; schizophrenia; standardized mortality ratio
SDGs
Other Subjects
neuroleptic agent; adolescent; adult; aged; bipolar disorder; cohort analysis; epidemiology; female; human; male; middle aged; mortality; schizophrenia; Taiwan; trends; very elderly; young adult; Adolescent; Adult; Aged; Aged, 80 and over; Antipsychotic Agents; Bipolar Disorder; Cohort Studies; Female; Humans; Male; Middle Aged; Mortality; Schizophrenia; Taiwan; Young Adult
Publisher
Cambridge University Press
Type
journal article