Subsequent Dyslipidemia and Factors Associated with Mortality in Schizophrenia: A Population-Based Study in Taiwan

Abstract

Background: Persons with schizophrenia are at greater risk of developing subsequent medical conditions. To date, few studies have examined comprehensively the risks, mortality and survival rates in schizophrenia and subsequent dyslipidemia over different time periods. The objective of this study was to evaluate the occurrence of subsequent dyslipidemia after the diagnosis of schizophrenia, and factors associated with mortality and survival rate in patients with schizophrenia. Methods: We used a population-based cohort from Taiwan National Health Insurance Research Database, to investigate in patients whom were first diagnosed with schizophrenia during the period from 1997 through 2009, the risk of subsequent dyslipidemia during follow-up. Cumulative incidences and hazard ratios after adjusting for competing mortality risks were calculated. Results: A total of 20,964 eligible patients were included. Risks (i.e., comorbidity) and protective factors (i.e., statin use) have significant impacts on mortality. The mortality exhibits a U-shaped pattern by age. After 50, the risk of death increases with age. Risk of mortality before 50 increases with a decrease in age. Risks differed by the duration time to subsequent dyslipidemia after schizophrenia. Mean duration was 63.55 months in the survive group, and 43.19 months in the deceased group. The 5-, 10-, and 15-year survival rates for patients with schizophrenia and subsequent dyslipidemia were 97.5, 90, and 79.18%, respectively. Conclusion: Early occurrence of subsequent dyslipidemia is associated with increased overall mortality in patients with schizophrenia.

Inter-relationships of risk factors and pathways associated with all-cause mortality in patients with chronic schizophrenia

“…A previous study reported a 2.9-fold higher risk of all-cause mortality in patients with schizophrenia compared to the general population, and a 1.6-fold higher risk compared to controls matched for physical diseases ( 36 ). Although several risk factors including cardiovascular diseases ( 37 ), stroke ( 37 , 38 ), smoking ( 39 ), physical fitness and inactivity ( 40 ), obesity ( 41 ), dyslipidemia ( 42 ), any cancer ( 43 ), and suicide ( 44 ) have been associated with all-cause mortality in patients with schizophrenia, the exact pathophysiological mechanisms have yet to be clarified.…”