Persons with schizophrenia and with bipolar disorder have a reduced life expectancy due largely to death from natural causes. The reasons for this increased mortality have not been completely defined. We prospectively assessed a cohort of persons with schizophrenia and one with bipolar disorder with a clinical evaluation and a blood sample from which immune and infectious disease markers were measured. Mortality was determined with data from the National Death Index following a period of up to 14years. We examined the role of demographic, clinical, and serological factors on mortality in bivariate and multivariate models. A total of 43/710 (6.1%) persons with schizophrenia and 12/406 (3.0%) with bipolar disorder died of natural causes. In the schizophrenia group, mortality was predicted by the following variables in a multivariate model: cigarette smoking (RR=6.93, 95% CI 1.59, 30.1, p=0.0099); autoimmune disorder (RR=8.08, 95% CI 2.50, 26.1, p=0.00047); gastrointestinal disorder (GI) (RR=3.53, 95% CI 1.43, 8.69 p=0.0061); and reduced maternal education (RR=0.84, 95% CI 0.72, 0.97), p=0.018. The combination of smoking and an autoimmune disorder yielded an unadjusted relative risk of 18.1 for mortality, and the combination of smoking and a GI disorder an unadjusted relative risk of 9.45, compared with individuals with neither risk factor. In the bipolar disorder group, significant bivariate predictors of mortality included lower cognitive score (RR=0.95, p=.0085) and the presence of type 1 or 2 diabetes (RR=3.90, p=.026). Given the extraordinary high risk of death due to smoking in schizophrenia, smoking cessation remains an urgent priority.
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http://dx.doi.org/10.1016/j.schres.2015.11.010 | DOI Listing |
J Clin Psychopharmacol
January 2025
Department of Pharmacy, Mayo Clinic, Rochester, MN.
Background: Clozapine is effective for treatment-resistant schizophrenia and bipolar disorder but is often discontinued due to adverse effects. This study compared early clozapine discontinuation rates and reasons in patients with mood and psychotic disorders.
Methods: Data from all individuals with mood or psychotic disorders who initiated clozapine for the first time at the inpatient psychiatric unit of Mayo Clinic, Rochester, Minnesota, between 2014 and 2022 were retrospectively analyzed.
Int J Neuropsychopharmacol
January 2025
Centre for Clinical Neurosciences, McMaster University, Hamilton, ON.
Background: Bipolar disorder (BD) has been associated with impaired cellular resilience. Recent studies have shown abnormalities in the unfolded protein response (UPR) in BD. The UPR is the cellular response to endoplasmic reticulum (ER) stress.
View Article and Find Full Text PDFHuman genomic studies have identified protein-truncating variants in associated with both bipolar disorder and schizophrenia, implicating a shared disease mechanism driven by loss-of-function. AKAP11, a protein kinase A (PKA) adaptor, plays a key role in degrading the PKA-RI complex through selective autophagy. However, the neuronal functions of AKAP11 and the impact of its loss-of-function remains largely uncharacterized.
View Article and Find Full Text PDFObjective: To examine the association between mood disorders in pregnancy and postpartum and peripartum cardiomyopathy (PPCM).
Methods: Retrospective cohort study utilizing the National Inpatient Sample from the Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality of pregnant and postpartum patients from 2017-2019. Patients were separated into two groups based on ICD-10 coding for presence or absence of mood disorder (depression, bipolar depression, anxiety, or other mood diagnosis).
EClinicalMedicine
January 2025
College of Competitive Sports, Beijing Sport University, Beijing, China.
Background: Given the distinctive physiological characteristics of pregnant women, non-pharmacological therapies are increasingly being used to improve depressive and anxiety symptoms. Our objective was to explore and compare the impact of various non-pharmacological interventions in improving depressive and anxiety symptoms, and to identify the most effective strategies for pregnant women with depressive and/or anxiety symptoms.
Methods: We conducted a systematic search of PubMed, Embase, the Cochrane Library, and Web of Science for randomized controlled trials (RCTs) that compared non-pharmacological interventions to usual care, from the inception of each database up to October 5, 2024.
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