Schizophrenia and Life Expectancy

Reviewed by Hansa D. Bhargava, MD on January 27, 2021

If you or a loved one has been diagnosed with schizophrenia, you may find that you focus entirely on getting through day-to-day life. But there’s good reason to think about the future, too: People with schizophrenia tend to have lower life expectancy than those who don’t have the disease.

“Research studies over the past few decades suggest that life expectancy can be reduced by as much as 15 years on average in people diagnosed with schizophrenia,” says Keith Gallagher, MD, an assistant professor of psychiatry at the Yale School of Medicine in New Haven, CT. One 2015 study, for example, found that adults under the age of 65 with schizophrenia are 3½ times more likely to die in a given year than similarly aged people in the general population.

This may seem like a frightening fact, but there are things you can do to improve the odds. “I encourage patients and families to focus on those factors they have the power to influence, such as diet, exercise, smoking, and substance use,” Gallagher says. Here’s what you need to know.

Why the Risk of Death Is Higher

Schizophrenia itself isn’t life-threatening. But people who have it are more likely to have other health conditions that raise their chances of death. The 2015 study found that heart disease was the top cause of death in people with schizophrenia, accounting for about a quarter of all cases. Conditions like chronic obstructive pulmonary disease (COPD), type 2 diabetes, and lung cancer were also common causes of death.

“Adults with schizophrenia are about 10 times more likely to die of COPD and 7 times more likely to die of diabetes,” says a co-author of the study, Mark Olfson, MD, a psychiatrist at Columbia University Irving Medical Center in New York City.

Cigarette use is one reason why someone with schizophrenia may be more at risk of heart or lung disease. “Most people with schizophrenia smoke, and those who smoke tend to do so more heavily than people in the general population,” Olfson explains.

Antipsychotic medications that treat schizophrenia can also cause weight gain, as well as raising blood glucose, cholesterol, and blood pressure levels.

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Up to 85% of people with schizophrenia also have some kind of cognitive impairment, which can make it harder for them to make basic healthy lifestyle choices such as avoiding junk food and getting regular exercise, says Tiffany Herlands, PhD, an assistant professor of medical psychology in the Department of Psychiatry at Columbia University Irving Medical Center.

In addition, people with schizophrenia are more likely to take their own lives, especially if they are young, male, and white. This is especially true in the first years after diagnosis, when the illness may be most severe, which is one of the reasons why prompt treatment is so crucial. Social and economic status, race and ethnicity, and the stigma of mental illness all raise the risk that a person won’t get the medical care they deserve, Gallagher says.

Better Life Expectancy With Schizophrenia

Here are some ways to boost health when you have schizophrenia:

Keep up on medical care. “I’ve known many patients who prefer to avoid routine medical visits and health screenings,” Gallagher says. “Sometimes, this is directly related to symptoms of schizophrenia, which can make medical appointments tough to manage, but some of this may be due to stigma that people with schizophrenia experience in our health care system.” One way to work on this, he notes, is to find a primary care doctor who you like and who you trust to advocate for you when needed.

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Adopt smart stop-smoking strategies. The earlier people with schizophrenia are able to kick the habit, the better, Olfson says. The good news is that people with psychotic disorders like schizophrenia are actually more likely to quit successfully than those without the disorders. The best results are seen in patients who use the stop-smoking drug varenicline (Chantix), along with behavioral therapy for at least 12 weeks, according to a 2017 study. Talk to your doctor about what might work best for you.

Avoid alcohol. People with schizophrenia are more likely to develop alcoholism. This in turn can lead to long-term diseases such as high blood pressure, liver disease, and even some cancers. All of these conditions can affect your life expectancy. “People with schizophrenia also tend to have poor judgment, and alcohol can exacerbate it,” says Frank Chen, MD, chief medical director at Houston Behavioral Healthcare Hospital. “They’re more likely to act on impulses, which can cost them their life -- for example, if they drive drunk. It may also increase suicidal tendencies.”

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Make heart health a priority. If you or a loved one has schizophrenia, it’s very important to stay on top of numbers such as weight, blood pressure, blood glucose, and cholesterol, Olfson says. You may need to work with the doctor on a care plan that spells out a diet and exercise program to follow, Herlands says. In these cases, specific health and wellness mobile apps may also be helpful.

Caretakers can also play a key role in helping people with schizophrenia meet their health goals. “Whether it’s helping to get to doctors’ appointments, preparing healthy foods at home, talking about smoking, or exercising together, there are plenty of small ways loved ones can try to be supportive,” Gallagher says. If your loved one has significant symptoms of schizophrenia, urge them to talk with their psychiatrist. They might be able to switch medications or try long-acting injectable drugs.

“Being in good mental health sets the foundation for good long-term health habits,” he says.

WebMD Feature

Sources

SOURCES:

Keith Gallagher, MD, assistant professor of psychiatry, Yale School of Medicine, New Haven, CT.

JAMA Psychiatry: “Premature Mortality Among Adults With Schizophrenia in the United States.”

Mark Olfson, MD, psychiatrist, Columbia University Irving Medical Center, New York City.

Neuropsychiatric Disease Treatment: “Antipsychotic-associated weight gain: management strategies and impact on treatment adherence.”

Psychiatriki: “Cognitive impairments and psychopathological parameters in patients of the schizophrenic spectrum.”

Tiffany Herlands, PhD, assistant professor of medical psychology, Department of Psychiatry, Columbia University Irving Medical Center.

CNS Drugs: “Achieving Smoking Cessation in Individuals with Schizophrenia: Special Considerations.”

CDC: “Alcohol Use and Your Health.”

Frank Chen, MD, chief medical director, Houston Behavioral Healthcare Hospital.

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