Mortality Higher Among Depressed, Schizophrenic Smokers
The risk of tobacco-related mortality was significantly increased among patients with schizophrenia, bipolar disorder, and depression in a new study.
Despite the fact that research has shown heightened tobacco use among individuals with psychiatric conditions including those examined in the current study, tobacco-related mortality has not been extensively examined and tobacco use receives little clinical attention in psychiatric populations.
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In an attempt to determine mortality estimates for tobacco-related conditions among such individuals, researchers reviewed the hospital records of 174,277 patients with schizophrenia, 338,250 patients with depressive disorders, and 78,739 patients with bipolar disorder based on diagnoses from the International Classification of Diseases, 9th edition. All participants were aged 35 years or older at the mid-point of their follow-up period.
Standardized mortality ratios (SMRs) were calculated for 19 diseases, including different types of malignant neoplasms, cardiovascular conditions, and respiratory diseases, that are causally linked to tobacco use.
After adjusting for age, sex, and race, the SMRs for all tobacco-related conditions combined were 2.45 for schizophrenia, 1.57 for bipolar disorder, and 1.95 for depression.
In addition, approximately 53%, 48%, and 50% of total deaths in the schizophrenia, bipolar, and depression groups, respectively, were attributed to tobacco-related conditions.
“Given our primary results—which demonstrated significantly heightened patterns of tobacco-related mortality across all of our psychiatric cohorts—addressing tobacco use in these groups is a critical clinical and public-health concern, especially in light of the often limited clinical attention devoted to tobacco use among people with mental illnesses,” the authors wrote.
Some study limitations include the fact that the patient population was comprised of individuals with inpatient ICD-9 diagnoses of schizophrenia, bipolar disorder, and depression who had relatively severe illness, and therefore may have excluded those who had limited care access. In addition, information on the presence, frequency, intensity, and duration of tobacco use was not available.
This study was published in the Journal of Psychiatric Research.
-Meredith Edwards White
Reference
Callaghan RC, Veldhuizen S, Jeysingh T, et al. Patterns of tobacco-related mortality among individuals diagnosed with schizophrenia, bipolar disorder, or depression. J Psychiatr Res. 2014 Jan;48(1):102-10. doi: 10.1016/j.jpsychires.2013.09.014. Epub 2013 Sep 27.