Abstract:
:Clozapine can cause severe adverse effects yet it is associated with reduced mortality risk. We test the hypothesis this association is due to increased clinical monitoring and investigate risk of premature mortality from natural causes. We identified 14 754 individuals (879 deaths) with serious mental illness (SMI) including schizophrenia, schizoaffective and bipolar disorders aged ≥ 15 years in a large specialist mental healthcare case register linked to national mortality tracing. In this cohort study we modeled the effect of clozapine on mortality over a 5-year period (2007-2011) using Cox regression. Individuals prescribed clozapine had more severe psychopathology and poorer functional status. Many of the exposures associated with clozapine use were themselves risk factors for increased mortality. However, we identified a strong association between being prescribed clozapine and lower mortality which persisted after controlling for a broad range of potential confounders including clinical monitoring and markers of disease severity (adjusted hazard ratio 0.4; 95% CI 0.2-0.7; p = .001). This association remained after restricting the sample to those with a diagnosis of schizophrenia or those taking antipsychotics and after using propensity scores to reduce the impact of confounding by indication. Among individuals with SMI, those prescribed clozapine had a reduced risk of mortality due to both natural and unnatural causes. We found no evidence to indicate that lower mortality associated with clozapine in SMI was due to increased clinical monitoring or confounding factors. This is the first study to report an association between clozapine and reduced risk of mortality from natural causes.
journal_name
Schizophr Bulljournal_title
Schizophrenia bulletinauthors
Hayes RD,Downs J,Chang CK,Jackson RG,Shetty H,Broadbent M,Hotopf M,Stewart Rdoi
10.1093/schbul/sbu120subject
Has Abstractpub_date
2015-05-01 00:00:00pages
644-55issue
3eissn
0586-7614issn
1745-1701pii
sbu120journal_volume
41pub_type
杂志文章abstract:UNLABELLED:Early intervention is assumed to improve outcome in first-episode psychosis, but this has not been proven. OBJECTIVE:To study whether 1-year outcome will be better in a health care sector with early detection (ED) of psychosis compared with sectors with no early detection (no-ED). DESIGN:A quasi-experiment...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,多中心研究
doi:10.1093/schbul/sbl005
更新日期:2006-10-01 00:00:00
abstract::The author reviews a number of studies which have shown that the overall mortality among patients with schizophrenia is about twice that in the general population. The highest excess mortality is found in suicide and violent death, but there seems to be an increased mortality also in cardiovascular disorders. Whether ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/15.1.81
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:The clinical high-risk state for psychosis (HRP) is associated with an enhanced probability of developing a psychotic episode over a relatively short period of time. However, the extent to which different diagnostic types of illness develop remains unclear. METHODS:A systematic review was performed to ident...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析,评审
doi:10.1093/schbul/sbs060
更新日期:2013-07-01 00:00:00
abstract::We report an analysis of a large catchment area sample of patients with nonaffective functional psychoses presenting across all ages at onset. The male:female ratio was 1.56:1 in the 16-25-year age group; it reached unity around 30 years of age and declined to 0.38:1 in the 66-75-year group. Contrary to expectation, a...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/19.4.691
更新日期:1993-01-01 00:00:00
abstract::The nature and definition of schizotypy, as the latent liability for schizophrenia capable of generating various phenotypic and endophenotypic outcomes, is reviewed. The proceedings of the 2017 meeting of the International Consortium on Schizotypy Research are included in this Special Section and they are presented as...
journal_title:Schizophrenia bulletin
pub_type:
doi:10.1093/schbul/sby083
更新日期:2018-10-15 00:00:00
abstract::The sex chromosomes are strong candidates for a genetic locus for schizophrenia and the affective psychoses. Gender differences in the clinical expression of illness and familial risks, concordance for gender and illness in relatives, and an association of X chromosome anomalies with psychosis suggest an X chromosome ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/15.3.431
更新日期:1989-01-01 00:00:00
abstract::Persistent negative symptoms represent an alternative approach for assessing negative symptoms in the context of clinical trials. Persistent negative symptoms are designed to capture those symptoms that lead to functional impairment but are currently understudied and for which there are no currently available effectiv...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbl057
更新日期:2007-07-01 00:00:00
abstract::The success of the biological revolution in our understanding of schizophrenia, along with the lack of convincing evidence for the efficacy of global approaches to individual psychotherapy with schizophrenia, has led to the virtual disappearance of research and theory in this area. However, it seems timely to reexamin...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/15.3.349
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:The homicide of strangers by people with psychosis, referred to here as "stranger homicides," are rare and tragic events that generate adverse publicity for mental health services and have resulted in significant changes in mental health policy and law. AIM:To estimate the incidence of stranger homicides, u...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析
doi:10.1093/schbul/sbp112
更新日期:2011-05-01 00:00:00
abstract::Strong familial aggregation of schizophrenia has been reported but there is uncertainty concerning the degree of genetic contribution to the phenotypic variance of the disease. This study aimed to examine the familial aggregation and heritability of schizophrenia, and the relative risks (RRs) of other psychiatric dise...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbw159
更新日期:2017-09-01 00:00:00
abstract::Genetic variants conferring risk for schizophrenia (SCZ) have been extensively studied, but the role of posttranscriptional mechanisms in SCZ is not well studied. Here we performed the first genome-wide microRNA (miRNA) expression profiling in serum-derived exosome from 49 first-episode, drug-free SCZ patients and 46 ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sby191
更新日期:2019-10-24 00:00:00
abstract::The validity of a Hindi version of the Diagnostic Interview for Genetic Studies (DIGS) was investigated. The original English version was initially translated into Hindi. The Hindi version was then back-translated and compared with the original. Next, a group of psychiatric inpatients and outpatients were interviewed ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a033343
更新日期:1998-01-01 00:00:00
abstract::Increased critical stimulus duration among nonpsychotic subjects with Minnesota Multiphasic Personality Inventory 2-7-8 profiles in the Merritt and Balogh letter-discrimination procedure is consistent with the view that this abnormality might be a vulnerability indicator for a poor prognosis, chronic type of schizophr...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/11.3.344
更新日期:1985-01-01 00:00:00
abstract::Evidence for the existence of a genetic factor in the etiology of a significant proportion of the people diagnosed as having a schizophrenic disorder is reviewed. It is suggested that whatever is transmitted genetically need not be inherently pathologic and/or pathogenic. It is argued that only people who have certain...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/5.3.453
更新日期:1979-01-01 00:00:00
abstract::The left superior temporal sulcus (STS) plays an important role in integrating audiovisual information and is functionally connected to disparate regions of the brain. For the integration of gesture information in an abstract sentence context (metaphoric gestures), intact connectivity between the left STS and the infe...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbt110
更新日期:2014-07-01 00:00:00
abstract::Patients describe experiencing personal recovery despite ongoing symptoms of psychosis. The aim of the current research was to perform a meta-analysis investigating the relationship between clinical and personal recovery in patients with schizophrenia spectrum disorders. A comprehensive OvidSP database search was perf...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析,评审
doi:10.1093/schbul/sbx088
更新日期:2018-04-06 00:00:00
abstract::Clinical descriptions of perceptual and attentional anomalies in schizophrenia emphasize phenomena such as flooding, or inundation, by sensory stimuli. A failure of sensory "gating" mechanisms in the brain is hypothesized to account for these symptoms, and this hypothesis has led to a marked interest in their putative...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a033402
更新日期:1999-01-01 00:00:00
abstract::Social networks of 35 mentally ill persons were studied in Lao villages. Mental illness was associated with a decrease in size of social networks, disproportionate reliance on family, and asymmetric instrumental exchange. Nonkin "sponsors" provided assistance to those alienated from or abandoned by relatives. For thos...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/7.1.125
更新日期:1981-01-01 00:00:00
abstract::To better characterize hippocampal pathophysiology in schizophrenia, we conducted a longitudinal study evaluating hippocampal functional connectivity during resting state, using seeds prescribed in its anterior and posterior regions. We enrolled 34 unmedicated patients with schizophrenia or schizoaffective disorder (S...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbv228
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:Stressful life events have been implicated in the onset of psychotic disorders, but there are few robust studies. We sought to examine the nature and magnitude of associations between adult life events and difficulties and first-episode psychoses, particularly focusing on contextual characteristics, including...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbaa005
更新日期:2020-07-08 00:00:00
abstract:INTRODUCTION:Separable, but positively correlated, factors emerge from analyses of cognitive test data in schizophrenia and control samples (eg, verbal memory and processing speed) and these factors guide data reduction. Additionally, data support a hierarchical model of cognitive performance, in which these correlatio...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbq018
更新日期:2011-11-01 00:00:00
abstract:INTRODUCTION:ABT-288 is a highly potent histamine-3 receptor antagonist that has demonstrated pro-cognitive effects in preclinical models relevant to schizophrenia. This study evaluated the efficacy and safety of two doses of ABT-288 in the treatment of cognitive impairment associated with schizophrenia. METHODS:A ran...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/schbul/sbt240
更新日期:2014-11-01 00:00:00
abstract::Recent advances in functional genomics have facilitated the identification of multiple genes and isoforms associated with the genetic risk of schizophrenia, yet the causal variations remain largely unclear. A previous study reported that the schizophrenia risk single-nucleotide polymorphism (SNP) rs7085104 at 10q24.32...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbaa098
更新日期:2021-01-23 00:00:00
abstract::Impaired attention is commonly observed among schizophrenia patients and those at genetic risk for the disease. This article reviews over 40 studies that used various versions of the Continuous Performance Test (CPT) as the primary measure of attention. These studies of normal subjects, affected patients, and various ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/20.1.31
更新日期:1994-01-01 00:00:00
abstract::Similarities in clinical course, age of onset, geographical distribution, and immunological responses of patients with schizophrenia and multiple sclerosis (MS) suggest that these two common illnesses of young adults may belong to a similar class of disorders. This review examines some of the similarities and differen...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/14.2.231
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:There is evidence of a positive association between insight and depression among patients with schizophrenia. Self-stigma was shown to play a mediating role in this association. We attempted to broaden this concept by investigating insight as a potential moderator of the association between depressive sympto...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbw024
更新日期:2016-05-01 00:00:00
abstract::This cross-sectional study examined the relationships between neurocognitive and social functioning in a sample of 80 outpatients with DSM-III-R schizophrenia. The neurocognitive battery included measures of verbal ability, verbal memory, visual memory, executive functioning, visual-spatial organization, vigilance, an...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a033363
更新日期:1999-01-01 00:00:00
abstract::The purpose of this study was to assess how neurocognition and social cognition were associated with initial functional level and with rates of functional change in intensive community-based psychosocial rehabilitation interventions that have been shown to yield significant functional change for individuals diagnosed ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,多中心研究
doi:10.1093/schbul/sbl072
更新日期:2007-09-01 00:00:00
abstract::Given the variety of "organic" or "toxic" conditions that may produce, precipitate, or exacerbate psychotic disorders, it is important to attempt to clarify existing nosologies and to highlight the need for research strategies that may help to validate relevant distinctions. This review provides a brief discussion of ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/17.1.69
更新日期:1991-01-01 00:00:00
abstract::Standardized recovery criteria go beyond symptom remission and put special emphasis on personal and social functioning in residence, work, and leisure. Against this background, evidence-based integrated approaches combining cognitive remediation with social skills therapy show promise for improving functional recovery...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析,评审
doi:10.1093/schbul/sbr072
更新日期:2011-09-01 00:00:00