Abstract
BACKGROUND: Schizophrenia is associated with premature mortality, but most evidence comes from high-income regions. AIMS: This study aimed to estimate the excess mortality associated with schizophrenia in southern China. METHOD: We linked register data from a nationwide information system for psychosis to death registers. Individuals diagnosed with schizophrenia and residing in Guangzhou between 2014 and 2021 were included. Standardised mortality ratios (SMRs) were calculated to compare the mortality of people with schizophrenia with that of the general population. Life expectancy, potential years of life lost (PYLL) and years of life lost (YLL) were estimated for all-cause mortality and specific causes of death. Gender difference in these metrics was examined. RESULTS: There were 3684 deaths (11.3%) during the study period. The leading causes of death were circulatory, neoplastic and respiratory diseases. The mortality rate among people with schizophrenia was twofold greater than in the general population, with a greater risk associated with unnatural causes than natural causes. The risk of mortality due to suicide was 15-fold higher than that of the general population. The life expectancy in schizophrenia was around 60 years, which is 21 years shorter than that for the general population. Schizophrenia was associated with substantial premature mortality burden, showing greater impact in men than women. CONCLUSIONS: Schizophrenia is associated with increased premature mortality, reduced life expectancy and substantial PYLL. The enduring disparity in mortality underscores an imminent call for targeted interventions aimed at suicide prevention and enhancement of the physical well-being of people with schizophrenia.