Predictors and shared traits of longevity within 1 year before death in patients with schizophrenia receiving long-term care: 3-year retrospective cross-sectional study.

IF 3.9 3区 医学 Q1 PSYCHIATRY BJPsych Open Pub Date : 2024-10-08 DOI:10.1192/bjo.2024.796
Chuan-Hsun Yu, Tsung-Cheng Hsieh
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Abstract

Background: Research on schizophrenia and life expectancy has mainly focused on premature mortality.

Aims: This study investigates factors associated with longevity in patients with schizophrenia receiving long-term care and identifies shared traits among these individuals.

Method: A retrospective cross-sectional study analysing the clinical records of 138 patients with schizophrenia who died between 2015 and 2017 in a psychiatric long-term care facility was conducted. Longevity was defined by life tables drawn from the national health database. Variables were compared between longevity and control groups to determine predictors of longer lifespans. Cluster analysis was employed to identify shared traits among individuals with longevity. Causes of death by age were compared.

Results: In the long-term care setting, of the 138 participants, 45 were in the longevity group. This group had more males, lower antipsychotic doses, but more mobility issues. Significant predictors of longevity included older age at onset, longer length of stay, lower activities of daily living scores and a hypertension diagnosis. Cluster analysis revealed two patterns, suggesting that poorer health indicators did not necessarily lead to shorter lives. Fatalities caused by pneumonia were associated with a higher age, compared to those from cancer and choking.

Conclusions: Addressing modifiable risk factors enhances life expectancy in patients with schizophrenia, especially for males, while the age at onset may play a significant role. An integrated long-term care model with close monitoring and timely provision of mental and general healthcare may help extend lifespans. Further research is needed to balance long-term residential care and community-based care for elderly patients with schizophrenia.

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接受长期护理的精神分裂症患者死亡前 1 年内长寿的预测因素和共同特征:为期三年的回顾性横断面研究。
背景:有关精神分裂症和预期寿命的研究主要集中在过早死亡方面:关于精神分裂症和预期寿命的研究主要集中在过早死亡方面。目的:本研究调查了接受长期护理的精神分裂症患者的长寿相关因素,并确定了这些人的共同特征:这项回顾性横断面研究分析了2015年至2017年间在精神科长期护理机构死亡的138名精神分裂症患者的临床记录。寿命由国家健康数据库中的生命表定义。比较了长寿组和对照组的变量,以确定长寿的预测因素。采用聚类分析来确定长寿者的共同特征。比较了各年龄段的死亡原因:在长期护理环境中,138 名参与者中有 45 人属于长寿组。该组中男性较多,抗精神病药物剂量较低,但行动不便者较多。长寿组的重要预测因素包括发病年龄较大、住院时间较长、日常生活活动评分较低以及高血压诊断。聚类分析揭示了两种模式,表明健康指标较差并不一定导致寿命较短。与癌症和窒息造成的死亡相比,肺炎造成的死亡与较高的年龄有关:解决可改变的风险因素可以延长精神分裂症患者的预期寿命,尤其是男性患者,而发病年龄可能起着重要作用。密切监测并及时提供精神和普通医疗服务的综合长期护理模式可能有助于延长患者的寿命。需要进一步开展研究,以平衡对老年精神分裂症患者的长期住院护理和社区护理。
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来源期刊
BJPsych Open
BJPsych Open Medicine-Psychiatry and Mental Health
CiteScore
6.30
自引率
3.70%
发文量
610
审稿时长
16 weeks
期刊介绍: Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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