Natural cause mortality in persons with serious mental illness

F. Dickerson, A. Origoni, J. Schroeder, M. Adamos, E. Katsafanas, S. Khushalani, C. L.G. Savage, L. A.B. Schweinfurth, C. Stallings, K. Sweeney, R. Yolken

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18 Scopus citations


Objective: To identify the determinants of natural cause mortality in a cohort of individuals with serious mental illness assessed prospectively. Method: Persons with schizophrenia (n = 789) and bipolar disorder (n = 498), mean age of 38 (s.d. 12.6) years, underwent an in-person clinical assessment. They also had a blood sample drawn from which infectious disease markers were measured. Mortality was subsequently determined utilizing data from the National Death Index following a period of up to 16.9 years. Results: A total of 6.8% (87 of 1287) of persons died of natural causes. Mortality was predicted in a multivariate model by baseline cigarette smoking (RR = 6.29, 95% CI 1.41, 3.72, P = 0.00076); divorced or widowed status (RR = 1.90, CI 1.21, 2.99); reduced cognitive score (RR = 0.73, CI 0.61, 0.87); receipt of antidepressant medication (RR = 1.74, CI 1.12, 2.71); elevated levels of antibodies to Epstein–Barr virus (EBV) (RR = 1.29, CI 1.01, 1.66); and a genitourinary (RR = 1.82, CI 1.16, 2.86), respiratory (RR = 1.82, CI 1.16, 2.86), or cardiac (RR = 2.09, CI 1.33, 3.29) condition. There was an additive effect of smoking and both a cardiac and a respiratory condition but not elevated EBV antibody levels. Conclusion: Smoking is a modifiable behaviour which is associated with mortality in this population.

Original languageEnglish (US)
Pages (from-to)371-379
Number of pages9
JournalActa Psychiatrica Scandinavica
Issue number5
StatePublished - May 2018


  • bipolar disorder
  • mortality
  • schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health


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