20-year follow-up study of physical morbidity and mortality in relationship to antipsychotic treatment in a nationwide cohort of 62,250 patients with schizophrenia (FIN20)
World Psychiatry Jan 16, 2020
Taipale H, et al. - Researchers evaluated the risk of hospitalization due to physical health problems, as a marker for severe physical morbidity, and the risk of all-cause mortality, as well as of cardiovascular and suicidal death, correlated with antipsychotic use in patients treated for schizophrenia. They conducted a nationwide, register-based cohort study including 62,250 patients treated for schizophrenia in inpatient care between 1972 and 2014 in Finland, with up to 20 years of follow-up (median: 14.1 years). For any somatic hospitalization and cardiovascular hospitalization, the adjusted hazard ratios (aHRs) of 1.00 (95% CI: 0.98-1.03) and 1.00 (95% CI: 0.92-1.07) were identified during the use of any antipsychotic vs non-exposure periods within the same individual. During use vs non-use of any antipsychotic, the aHRs of 0.48 (95% CI: 0.46-0.51) for all-cause mortality, 0.62 (95% CI: 0.57-0.67) for cardiovascular mortality, and 0.52 (95% CI: 0.43-0.62) for suicide mortality were observed. The use of clozapine was correlated with the most beneficial mortality outcome in terms of all-cause (aHR = 0.39, 95% CI: 0.36-0.43), cardiovascular (aHR = 0.55, 95% CI: 0.47-0.64) and suicide mortality (aHR = 0.21, 95% CI: 0.15-0.29). Data suggested no increase in severe physical morbidity leading to hospitalization in correlation to long-term antipsychotic use, however, their use is correlated with substantially decreased mortality, especially among patients treated with clozapine.
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