Heart disease treatment and mortality in schizophrenia and bipolar disorder - Changes in the danish population between 1994 and 2006
Heart disease treatment and mortality in schizophrenia and bipolar disorder - Changes in the danish population between 1994 and 2006
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DOI：
10.1016/j.jpsychires.2010.04.027
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发表时间：
2011-01-01
影响因子：
4.8
通讯作者：
Nordentoft, Merete
中科院分区：
文献类型：
--
作者：
Laursen, Thomas Munk;Nordentoft, Merete
精神分裂症和双相情感障碍患者的心脏病死亡率比一般人群高得多。目的是比较1994年至2006年期间普通人群与精神分裂症、双相情感障碍或其他精神疾病患者的躯体住院率和侵入性心脏病手术率以及心脏病死亡率。生存分析用于分析居住在丹麦的所有人队列中的心脏病死亡率和躯体护理趋势。在研究期间，精神分裂症患者的心脏病死亡率显著上升：与一般人群相比，死亡率比率每两年上升1.12（95%置信区间（CI）1.08-1.15）。对于双相情感障碍患者[1.02（0.98-1.05），无显著性]或其他精神疾病患者[1.00（0.99-1.01），无显著性]，情况并非如此。在整个期间，精神分裂症患者的住院率和侵入性心脏手术比一般人群低。与其他队列成员相比，精神分裂症患者心脏病的死亡率较高（呈上升趋势），部分原因是侵入性心脏手术的发生率较低。然而，其他原因，如抗精神病药物引起的体重增加，一级预防和难以遵循戒烟建议也可能是部分原因。研究结果呼吁更多地关注这组患者的躯体护理和生活方式因素的改善。(C)2010爱思唯尔有限公司保留所有权利。
Persons with schizophrenia and bipolar disorder have much higher heart disease mortality rates than the general population. The objective was to compare the general population with persons with schizophrenia, bipolar disorder or other psychiatric disorders in terms of rates of somatic hospitalization and invasive heart disease procedures, and in terms of heart disease mortality during the period 1994 to 2006. Survival analysis was used to analyze heart disease mortality and somatic care trends in a cohort of all persons residing in Denmark. During the study period, heart disease mortality rose significantly among persons with schizophrenia: compared with the general population, the rise in the mortality rate ratio equalled 1.12 (95% confidence interval (CI) 1.08-1.15) every second year. This was not the case for persons with bipolar disorder [1.02 (0.98-1.05), not significant) or other psychiatric disorders [1.00 (0.99-1.01), not significant]. The entire period saw a lower hospitalization rate and fewer invasive cardiac procedures among persons with schizophrenia than among the general population. The higher mortality (with increasing trends) from heart disease in persons with schizophrenia compared to the rest of the cohort members can be explained partly by low rates of invasive cardiac procedures. However, other reasons, such as antipsychotic-induced weight gain, primary prevention, and difficulty following smoking cessation advice could also be part of the explanation. The results call for a greater focus on improvement in somatic care and lifestyle factors for this group of patients. (C) 2010 Elsevier Ltd. All rights reserved.