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Mortality risk in people with schizophrenia may vary according to class of antipsychotic used and concomitant medication

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Question

Question: Is schizophrenia associated with an increased risk of mortality, and do different classes of antipsychotics or other medications contribute to mortality risk?

People: 105 141 individuals were selected from the Agis Health Insurance Company database; 7415 patients with schizophrenia and 97 726 randomly selected controls. The schizophrenia case definition included a diagnosis-related group coding for schizophrenia in 2008 and at least one filled prescription for antipsychotic medication between 2006 and 2008. The schizophrenia group had a mean age of 45.5 years and the control group had a mean age of 39.9 years.

Setting: The urbanised population, central The Netherlands; from 2006 to 2008.

Risk factors: Having schizophrenia treated with an antipsychotic medication; taking different classes of antipsychotic medication (first generation, second generation or combination of the two); use of concomitant medications (anticholinergics, antidepressants, anxiolytics/hypnotics and/or mood stabilisers). All analyses were adjusted for age and sex.

Outcomes: All-cause mortality (in 2008 only).

Methods

Design: Retrospective cohort study.

Follow-up period: Mortality assessed over 1 year (assessed retrospectively).

Main results

There was a significantly higher death rate among people with schizophrenia who were taking antipsychotic …

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