Body mass index and mortality in patients with schizophrenia spectrum disorders: a cohort study in a South London catchment area.
Gen Psychiatr
; 35(5): e100819, 2022.
Article
em En
| MEDLINE
| ID: mdl-36447757
ABSTRACT
Background:
People with schizophrenia have a high premature mortality risk. Obesity is a key potential underlying risk factor that is relatively unevaluated to date.Aims:
In this study, we investigated the associations of routinely recorded body size with all-cause mortality and deaths from common causes in a large cohort of people with schizophrenia spectrum disorders.Methods:
We assembled a retrospective observational cohort using data from a large mental health service in South London. We followed all patients over the age of 18 years with a clinical diagnosis of schizophrenia spectrum disorders from the date of their first recorded body mass index (BMI) between 1 January 2007 and 31 March 2018.Results:
Of 11 900 patients with a BMI recording, 1566 died. The Cox proportional hazards regression models, after adjusting for sociodemographic, socioeconomic variables and comorbidities, indicated that all-cause mortality was only associated with underweight status compared with healthy weight status (hazard ratio (HR) 1.33, 95% confidence interval (CI) 1.01 to 1.76). Obesity (HR 1.24, 95% CI 1.01 to 1.52) and morbid obesity (HR 1.54, 95% CI 1.03 to 2.42) were associated with all-cause mortality in the 18-45 years age range, and obesity was associated with lower risk (HR 0.66, 95% CI 0.50 to 0.87) in those aged 65+ years. Cancer mortality was raised in underweight individuals (HR 1.93, 95% CI 1.03 to 4.10) and respiratory disease mortality raised in those with morbid obesity (HR 2.17, 95% CI 1.02 to 5.22).Conclusions:
Overall, being underweight was associated with higher mortality in this disorder group; however, this was potentially accounted for by frailty in older age groups, and obesity was a risk factor for premature mortality in younger ages. The impact of obesity on life expectancy for people with schizophrenia spectrum disorders is clear from our findings. A deeper biological understanding of the relationship between these diseases and schizophrenia will help improve clinical practice.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Gen Psychiatr
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Reino Unido