Citation

Altamura AC, Vismara S, Montresor C, Russo M, Tacchini G. Riv. Psichiatr. 2002; 37(5): 213-224.

Copyright

(Copyright © 2002, Il Pensiero Scientifico Editore)

DOI

unavailable

PMID

unavailable

Abstract

This work systematically analyzes the most recent data on mortality causes and suicidal behaviour in schizophrenic patients. Among them, mortality is about twice that of normal population and affects mainly the age range between 20 and 40 years, whilst it is comparable to that of normal subjects in the older age ranges. This excess of mortality cannot be exclusively attributed to the increase in the suicide rate; in fact, the increase of deaths due to natural causes is to be considered, particularly infective, cardiovascular, and metabolic diseases, mainly diabetes. An undoubtedly prominent role is played by the life style of such patients, often heavy smokers, obese or malnourished, living in the streets, often abusing alcohol or other substances as a self-medication attempt. A minor role is played by the effects of antipsychotic drugs. In the past it was believed that cancer deaths in schizophrenic patients were less than those of normal controls; nowadays this is true only for pulmonary tumors, notwithstanding the high proportion of heavy smokers. On the contrary, the negative association between schizophrenia and autoimmune diseases, above all rheumatoid arthritis and allergies, appears to be confirmed. The most important non-natural cause of death obviously is suicide; it has an incidence about 20 times higher than in normal population and is most likely in the first days after hospital discharge, and it is usually performed with methods with a high success chance, such as hanging and self-defenestration. At present, suicidal behaviours of schizophrenic patients can be prevented by using atypical antipsychotic compounds, which are effective on the psychosis and its positive and negative symptoms, on depression, and on hostility.

Language: it

Keywords

adult; alcohol abuse; allergy; amisulpride; amitriptyline; antidepressant agent; autoimmune disease; automutilation; cardiotoxicity; cardiovascular disease; cause of death; clozapine; controlled study; depression; diabetes mellitus; female; haloperidol; hanging; high risk population; hostility; human; incidence; infection; lifestyle; male; malnutrition; metabolic disorder; mortality; Mortality; negative syndrome; neuroleptic agent; obesity; positive syndrome; Prevention; quetiapine; review; rheumatoid arthritis; risk assessment; risk factor; risperidone; schizophrenia; Schizophrenia; self medication; smoking; suicidal behavior; Suicide; ziprasidone