Salute mentale e diseguaglianze: eccesso di mortalità dei pazienti torinesi ricoverati per schizofrenia

[Machine translation] Literature studies have observed double mortality rates in people with schizophrenia compared to the general population, with a life expectancy reduced from 10 to 25 years compared to that of healthy controls of the same age. This mortality differential is also observed in the first period following hospitalization. To explain this differential, the greater vulnerability of these individuals for risky behavior and pathologies related to lifestyles, treatment with antipsychotic drugs and low socioeconomic status have been called into question. A cohort study was conducted on people hospitalized for schizophrenia, bipolar disorder, paranoid state and other non-organic psychoses in Turin between 1995 and 2010, evaluating the risk of death from all causes and from some specific causes one year after discharge. The study population consists of 8,164 people living in Turin hospitalized between January 1, 1995 and December 31, 2010 for one of the psychiatric diseases considered (schizophrenia, bipolar disorder, paranoid state and other non-organic psychoses). To recover the information of interest, the identified SDOs were linked to the historic Turin registry, the 2001 census, the mortality archive and the archive of pharmaceutical prescriptions of the Piedmont Region. The standardized mortality ratios (SMR) of the cohort to the general population of Turin have been calculated for all causes and for specific causes of mortality. Patients hospitalized for schizophrenia, bipolar disorder, paranoid state and other non-organic psychoses during the period have a mortality rate 4 times higher than the general population. SMRs are particularly high in the 15-44 age group, and especially with regard to mortality due to suicide, respiratory diseases, alcohol-related diseases, cardiac ischaemia, metabolic disorders, and related smoking disorders. The excess mortality observed in the year following hospitalization for schizophrenia, bipolar disorder, paranoid state and other non-organic psychoses are very high, especially among young people. Appropriate countering activities and a better understanding of the mechanisms for generating the observed inequalities appear necessary.