SA57. Life Expectancy and Years of Potential Life Lost in Schizophrenia: A Systematic Review and Meta-Analysis

Abstract

Background: Among all the negative outcomes associated with schizophrenia, a multitude of studies have investigated and identified an increased mortality rate. Several systematic reviews and meta-analyses have been conducted, occasionally including more than 100 studies. These reviews and meta-analyses have typically focused on establishing the standardized mortality ratio, that is, a relative measure of mortality compared to the background population. Other systematic reviews have focused on predictors of increased mortality within populations with schizophrenia, whereas a third group of reviews have focused on relative risks or risk factors for cause-specific mortality, for example, suicide and cardiovascular mortality. While relative measures of mortality are useful, they may be difficult to interpret. To our knowledge, no studies have systematically reviewed the literature regarding life expectancy or years of potential life lost in patients diagnosed with schizophrenia. Similarly, it has not been established if or how these parameters vary over time or geographical locations or according to comorbid risk factors such as substance use disorders or somatic conditions. With the present systematic review and meta-analysis, we aimed to (1) identify studies and synthesize their findings on life expectancy in people with schizophrenia; (a) if applicable, stratify these findings by subgroups. (2) Identify studies and synthesize their findings on to years of potential life lost in people with schizophrenia; (a) if applicable, stratify these findings by subgroups. Methods: The protocol for this systematic review was registered at PROSPERO before starting literature searches, under the registration number CRD42016043673. We searched the following bibliographical databases for published studies: Medline (through PubMed), Psycinfo, Embase, Cinahl, and Web of Science. We included studies reporting data on either life expectancy or years of potential life lost in patients diagnosed with schizophrenia according to ICD, DSM, or RDC. Results: We identified 15 studies reporting life expectancy and / or years of potential life lost. The studies included more than 300 000 individuals with schizophrenia. Five studies allowed for calculation of years of potential life lost at birth. The weighted average years of potential life lost was 15.14 years. Two of these studies allowed distinction by sex, giving 15.76 years for men and 11.58 years for women. Synthesizing years of potential life lost at any given age allowed inclusion of all studies, for a total of 21.20 years. Further results will be presented at the conference. Conclusion: Schizophrenia is associated with a decrease in life expectancy of around 15 to 21 years, indicating a high need for efforts to reduce this mortality gap.