11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study)
11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study)
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DOI：
10.1016/s0140-6736(09)60742-x
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发表时间：
2009-08-22
期刊：
影响因子：
168.9
通讯作者：
Haukka, Jari
中科院分区：
文献类型：
--
作者：
Tiihonen, Jari;Lonnqvist, Jouko;Haukka, Jari
背景：人们普遍认为，20世纪90年代第二代抗精神病药物的引入对精神分裂症患者的死亡率产生了不利影响。我们的目的是建立抗精神病药物对这类患者死亡率的长期贡献。方法利用芬兰全国登记的数据，比较1996至2006年间66 881名患者的特定原因死亡率与总人口(520万)的死亡率，并将这些数据与抗精神病药物的使用联系起来。我们测量了门诊精神分裂症患者在当前和累积使用任何抗精神病药物期间的全因死亡率，以及与奋乃静使用的六种最常用抗精神病药物的接触情况。结果发现，尽管第二代抗精神病药物的使用比例在随访期间从13%上升到%，但精神分裂症患者和普通人群之间的预期寿命差距在1996年(25岁)和2006年(22.5岁)之间并没有扩大。与目前使用的奋乃静相比，奎硫平的总体死亡率风险最高(调整后的危险比[HR]1.41，95%可信区间1.09-1.82)，氯氮平的风险最低(0.74，0.60-0.91；氯氮平与奋乃静的差值p=0.0045，p<0.05)。
Background The introduction of second-generation antipsychotic drugs during the 1990s is widely believed to have adversely affected mortality of patients with schizophrenia. Our aim was to establish the long-term contribution of antipsychotic drugs to mortality in such patients.Methods Nationwide registers in Finland were used to compare the cause-specific mortality in 66 881 patients versus the total population (5.2 million) between 1996, and 2006, and to link these data with the use of antipsychotic drugs. We measured the all-cause mortality of patients with schizophrenia in outpatient care during current and cumulative exposure to any antipsychotic drug versus no use of these drugs, and exposure to the six most frequently used antipsychotic drugs compared with perphenazine use.Findings Although the proportional use of second-generation antipsychotic drugs rose from 13% to 64% during follow-up the gap in life expectancy between patients with schizophrenia and the general popullation did not widen between 1996 (25 years), and 2006 (22.5 years). Compared with current use of perphenazine, the highest risk for overall mortality was recorded for quetiapine (adjusted hazard ratio [HR] 1.41, 95% CI 1.09-1.82), and the lowest risk for clozapine (0.74, 0.60-0.91; p=0.0045 for the difference between clozapine vs perphenazine, and p