University of Oulu

Nina Rautio, Jouko Miettunen, Erika Jääskeläinen, Tanja Nordström, Matti Isohanni, Jussi Seppälä, Do adverse perinatal events predict mortality in schizophrenia during midlife?, Schizophrenia Research, Volume 179, 2017, Pages 23-29, ISSN 0920-9964,

Do adverse perinatal events predict mortality in schizophrenia during midlife?

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Author: Rautio, Nina1,2; Miettunen, Jouko1,3,4; Jääskeläinen, Erika1,4,5;
Organizations: 1Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
2Unit of Primary Health Care, Oulu University Hospital, OYS, P.O. Box 20, 90029 Oulu, Finland
3Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
4Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
5Oulu Occupational Health, Hallituskatu 36 B, 90100 Oulu, Finland
6Department of Psychiatry, South-Savo Hospital District, Porrassalmenkatu 35-37, 50100 Mikkeli, Finland
7Psychiatric Services, Carea, Kymenlaakso Social and Health Services, Kotkantie 41, 48210 Kotka, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
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Language: English
Published: Elsevier, 2017
Publish Date: 2018-05-02


Background: We examined mortality in schizophrenia spectrum disorder (SSD) and non-schizophrenic psychosis (NSSD) compared to individuals without psychosis, and whether perinatal factors predict mortality.

Methods: Within Northern Finland Birth Cohort 1966 (n = 10 933; 203 with SSD, 178 with NSSD), mortality was followed until end of 2011 by national register. Wantedness of pregnancy, mother’s antenatal depression, smoking and age, parity, paternal socio-economic status (SES) and family type at birth were examined as predictors of mortality.

Results: Mortality was higher in SSD (hazard ratio (HR) 3.60; 95% confidence interval (CI) 2.38–5.45) and NSSD (4.05; 2.65–6.17) compared to persons without psychoses after adjustment for gender. HR for natural death was 2.01 (0.82–4.91) in SSD and 4.63 (2.43–8.80) in NSSD after adjustment for gender. Corresponding figures for unnatural deaths were 4.71 (2.94–7.54) and 2.94 (1.56–5.55), respectively. Among non-psychotic persons, mother’s depression, smoking and low SES predicted mortality after adjustment for gender and parental psychoses (and SES), whereas among psychosis those whose father was a farmer had lower risk of mortality compared to those with high SES.

Conclusions: Individuals with SSD had a higher risk of unnatural death and individuals with NSSD of natural and unnatural deaths. Perinatal factors seem to be more important predictors of mortality in individuals without psychoses than with psychoses. According to population-based long follow-up data, it is important to pay attention to somatic morbidity behind natural causes of death in psychoses and to prevent suicides in order to prevent excess mortality.

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Series: Schizophrenia research
ISSN: 0920-9964
ISSN-E: 1573-2509
ISSN-L: 0920-9964
Volume: 179
Pages: 23 - 29
DOI: 10.1016/j.schres.2016.09.031
Type of Publication: A1 Journal article – refereed
Field of Science: 3112 Neurosciences
Funding: The research is funded by the EU under the Horizon 2020 research (grant agreement No 643552) and in part by grants from the Academy of Finland [#132071, #268336, #278286], the Sigrid Jusélius Foundation, the Jalmari and Rauha Ahokas Foundation, the Northern Finland Health Care Support Foundation, the Brain and Behavior Research Foundation and the European Union's Horizon 2020 research and innovation program [under grant agreement No 633595] for the DynaHEALTH action.
EU Grant Number: (643552) m-RESIST - Mobile Therapeutic Attention for Patients with Treatment Resistant Schizophrenia
(633595) DYNAHEALTH - Understanding the dynamic determinants of glucose homeostasis and social capability to promote Healthy and active aging
Academy of Finland Grant Number: 132071
Detailed Information: 132071 (Academy of Finland Funding decision)
268336 (Academy of Finland Funding decision)
278286 (Academy of Finland Funding decision)
Copyright information: © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license