Association between neighborhood deprivation and mortality in patients with schizophrenia and bipolar disorder-A nationwide follow-up study

被引:2
|
作者
Jansaker, Filip [1 ,2 ]
Sundquist, Jan [1 ,3 ,4 ]
Sundquist, Kristina [1 ,3 ,4 ]
Li, Xinjun [1 ]
机构
[1] Lund Univ, Ctr Primary Hlth Care Res, Lund, Sweden
[2] Copenhagen Univ Hosp, Rigshosp, Ctr Diagnost Invest, Dept Clin Microbiol, Copenhagen, Denmark
[3] Icahn Sch Med Mt Sinai, Dept Family Med & Community Hlth, Dept Populat Hlth Sci & Policy, New York, NY USA
[4] Shimane Univ, Ctr Community Based Healthcare Res & Educ CoHRE, Sch Med, Dept Funct Pathol, Matsue, Japan
关键词
bipolar disorder; mortality; neighborhood; schizophrenia; Sweden; CORONARY-HEART-DISEASE; PSYCHIATRIC MEDICATION PRESCRIPTION; SOCIOECONOMIC-STATUS; MULTILEVEL-ANALYSIS; HEALTH CONDITIONS; RISK-FACTORS; LUNG-CANCER; SWEDISH; COMORBIDITIES; INDIVIDUALS;
D O I
10.1111/bdi.13309
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
ObjectivesThe aim was to explore the association between neighborhood deprivation and all-cause mortality and cause-specific mortalities in patients with schizophrenia and bipolar disorder. A better understanding of this potential relationship may help to identify patients with schizophrenia and bipolar disorder with an increased mortality risk. MethodsThis nationwide study included practically all adults (>= 30 years) diagnosed with schizophrenia (n = 34,544) and bipolar disorder (n = 64,035) in Sweden (1997-2017). The association between neighborhood deprivation and mortality was explored using Cox regression. All models were conducted in both men and women and adjusted for individual-level sociodemographic factors and comorbidities. ResultsThere was an association between level of neighborhood deprivation and all-cause mortality in both groups. The adjusted hazard ratios for all-cause mortality associated with high compared to low neighborhood deprivation were 1.18 (95% confidence interval 1.11-1.25) in patients with schizophrenia and 1.33 (1.26-1.41) in patients with bipolar disorder. The two most common mortality causes in both groups were coronary heart disease and cancer. The mortality due to coronary heart disease increased when neighborhood deprivation increased and reached 1.37 (1.18-1.60) in patients with schizophrenia and 1.70 (1.44-2.01) in patients with bipolar disorder living in the most deprived neighborhoods. ConclusionsThis study shows that neighborhood deprivation is an important risk factor for all-cause mortality and most cause-specific mortalities among patients with schizophrenia and bipolar disorder. These findings could serve as aid to policymakers when allocating healthcare resources and to clinicians who encounter patients with these conditions in deprived neighborhoods.
引用
收藏
页码:489 / 498
页数:10
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