TITLE: Suicide Most Common Cause of Death in People w/
Schizophrenia—"Need for Continuous Suicide-Prevention Efforts for People
w/ Schizophrenia"
Thank you Dr. Pope
-- Forwarded --
The American Psychiatric Association issued the following news release:
Suicide Most Common Cause of Death in People With Schizophrenia, Study Finds
Suicide is the most common cause of death in patients who have
schizophrenia spectrum disorders, a study in Schizophrenia Bulletin has
found.
Marie Stefanie Kejser Starzer, M.D., of Copenhagen University Hospital
and colleagues analyzed data from the OPUS I study, a randomized
controlled trial of 578 patients experiencing their first episode of
psychosis. Patients enrolled in the study between January 1, 1998, and
December 31, 2000. When the patients enrolled, they were between 18 and
45 years old; had received first-time treatment for a diagnosis of
schizophrenia, schizotypal disorder, delusional disorder, acute or
transient psychosis, schizoaffective disorder, or nonspecific nonorganic
psychosis; and had not received antipsychotic medication for more than
12 weeks. They were randomized to receive treatment as usual or a
specialized early intervention that consisted of two years of assertive
community treatment (including family involvement, social skills
training, and psychoeducation) by a multidisciplinary team. Patients
were then assessed multiple times over a 20-year period.
By the end of 2021, 14.2% of the patients had died. Of those, 48.6% died
of external causes (for example, suicide or accidents) and 51.4% died of
medical conditions and diseases.
The most common cause of death was suicide, accounting for 27.8% of
deaths; followed by accidents at 13.9%; unspecified medical
abnormalities at 11.1%; and cardiovascular disease and cancer, both at 8.3%.
Death due to external causes, mostly suicide, occurred at a steady rate
throughout the study, whether the patients had received treatment as
usual or the specialized early intervention. Starzer and colleagues
wrote that this indicates a need for continuous suicide-prevention
efforts for people with schizophrenia.
“Early intervention services alone cannot address this issue, as the
risk [was] present long after [the specialized early intervention]
ended,” they wrote. “Perhaps more regular screening for suicide risk in
aging patients with schizophrenia could help prevent some of these late
suicides.”
Patients with a history of substance use had a higher risk of both
all-cause mortality and death from medical conditions and diseases.
“This underlines the importance of proper treatment of comorbid
substance use at any time after patients are diagnosed,” the researchers
wrote. They noted that the treatment of mental illness and the treatment
of substance use are often managed by separate entities. “Lack of
integrated treatment could be leading to suboptimal care for
dual-diagnosis patients, and a more multidimensional and non-categorical
treatment approach is needed.”
TITLE: Lithium May Reduce Psych Hospitalizations for People w/ Bipolar
OR MAJOR DEPRESSIVE DISORDER—N=260
Thank you Dr. Pope.
-------- Forwarded Message --------
The American Psychiatric Association issued the following news release:
Lithium May Reduce Psychiatric Hospitalizations in People With Bipolar,
Major Depressive Disorder
Taking lithium may significantly reduce the risk of psychiatric
hospitalization for people who have major depressive disorder or bipolar
disorder, a study in the Journal of Affective Disorders has found.
Maurizio Pompili, M.D, Ph.D., of Sapienza University in Rome and
colleagues analyzed data from the health records of 260 adult patients
who had either major depressive disorder or bipolar disorder and had
been admitted to the psychiatric unit of Sant’Andrea University Hospital
in Rome between February 2019 and August 2020.
The researchers compared the patients’ psychiatric hospitalization rates
for the 12 months before they started taking lithium with their
hospitalization rates during the first 12 months of taking lithium.
In the 12 months before taking lithium, 40.4% of the patients were
hospitalized, whereas only 11.2% of patients were hospitalized while
taking the drug.
This represents a 3.62-fold reduction in hospitalization during lithium
treatment.
The risk of hospitalization did not differ significantly between
patients with major depressive disorder and patients with bipolar
disorder either before or during treatment with lithium, suggesting that
taking lithium similarly benefitted both groups of patients.
Pompili and colleagues wrote that this finding was “unexpected,” as
other studies have suggested that lithium is more effective in patients
with bipolar disorder than those with major depressive disorder.
The risk of hospitalization also did not differ significantly between
patients who took only lithium and patients who also took other
psychotropic medications, with the exception of patients who also took
antipsychotics: Patients who took an antipsychotic along with lithium
had 21.1 times the odds of being hospitalized than those who did not
take an antipsychotic.
“An association of co-treatment with an antipsychotic plus lithium among
patients who required hospitalization probably represents greater
illness severity,” the researchers wrote.