Nonelderly adults with schizophrenia are 3.5 times more likely to die than adults in the general population.1,2 Each individual, on average, loses 28.5 years of life.1

Yet, more than 85% of these deaths are from natural causes, primarily cardiovascular disease, cancer, and diabetes mellitus.1

The questions are: “Why?” and “What can be done”?

One reason is that adults with schizophrenia are “less likely than their age-matched peers to receive adequate treatment for major medical conditions,” Mark Olfson, MD, MPH, and colleagues write in JAMA Psychiatry,2 thus compounding the risk of premature mortality.

“Many factors, including economic disadvantage, negative health behaviors, and difficulties accessing and adhering to medical treatments, are thought to contribute to premature mortality,” Dr. Olfson, of the Department of Psychiatry and New York State Psychiatric Institute, College of Physicians and Surgeons, Columbia University, New York, NY, and coauthors state. “Smoking, limited physical activity, obesity, elevated serum glucose level, hypertension, and dyslipidemia are all significantly more common in schizophrenia than in the general population.”

To characterize key sources of excess mortality among adults with schizophrenia, the investigators conducted a national examination of the Medicaid program, “the largest payer of health services for persons with schizophrenia in the United States.”

They identified 1,138,853 individuals in the schizophrenia cohort and 74,003 deaths, 65,553 of which had a known cause.