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Schizophrenia, neuroleptic medication and mortality

Published online by Cambridge University Press:  02 January 2018

Matti Joukamaa*
Tampere School of Public Health, University of Tampere and Department of Psychiatry Tampere University Hospital, Tampere
Markku Heliövaara
National Public Health Institute, Helsinki
Paul Knekt
National Public Health Institute, Helsinki
Arpo Aromaa
National Public Health Institute, Helsinki
Raimo Raitasalo
Social Insurance Institution, Helsinki
Ville Lehtinen
National Research and Development Centre for Welfare and Health, Helsinki, Finland
Dr Matti Joukamaa, Department of Social Psychiatry, Tampere School of Public Health, University of Tampere, FIN-33014, Finland. E-mail:
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There is an excess of death from natural causes among people with schizophrenia.


Schizophrenia and its treatment with neuroleptics were studied for their prediction of mortality in a representative population sample of 7217 Finns aged ⩾30 years.


A comprehensive health examination was carried out at baseline. Schizophrenia was determined using the Present State Examination and previous medical records.


During a 17-year follow-up, 39 of the 99 people with schizophrenia died. Adjusted for age and gender, the relative mortality risk between those with schizophrenia and others was 2.84 (95% CI 2.06–3.90), and was2.25 (95%CI1.61–3.15) after further adjusting for somatic diseases, blood pressure, cholesterol, body mass index, smoking, exercise, alcohol intake and education. The number of neuroleptics used at the time of the baseline survey showed a graded relation to mortality. Adjusted for age, gender, somatic diseases and other potential risk factors for premature death, the relative risk was 2.50 (95% CI1.46–4.30) per increment of one neuroleptic.


There is an urgent need to ascertain whether the high mortality in schizophrenia is attributable to the disorder itself or the antipsychotic medication.

Copyright © 2006 The Royal College of Psychiatrists 


See invited commentary, p. 128, this issue.

Declaration of Interest



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