Short summary

Living a long life with schizophrenia isn't common. We know that schizophrenia patients on average die 20 years before the general public. Even so, the number of elderly with schizophrenia is increasing concurrently with the expanding elderly demographic. Yet very little is known about their lives, how they cope with their condition and how it develops over time.

For society the total costs are tangible, amounting to DKK 3 bn annually for this patient group.

Learning why and how some do reach old age, and maybe even successfully so, could be a key knowledge in understanding factors associated with more positive outcomes.

Rationale

We know that schizophrenia patients on average die 20 years before the general public. Even so, the number of elderly with schizophrenia is increasing concurrently with the expanding elderly demographic.

For society the total costs are tangible, amounting to DKK 3 bn annually for this patient group.

There appear to be no Danish studies of this topic, and internationally too, research is sparse.

In this study we investigate the life course of schizophrenia patients in terms of their illness, general health and social prognosis over the lifespan as well as the current health status and social functioning of those alive +55 years old.

In order to obtain a broader health perspective, we compare the trajectory and prognosis of schizophrenia (a chronic mental illness) with type 1 diabetes (a chronic somatic illness) and in addition compare both cohorts with similar data for the general public.

Description of the cohort

The study consists of a nationwide register cohort study as well as a cross-sectional survey (interview study).

The register study has identified psychiatric admissions of all danes (age 18-40 yrs), who were registered with a schizophrenia diagnosis in 1970-1979 (n=4996).

One hundred and fifty randomly drawn surviving members (+55 yrs) of the register cohort resident in the Region of Southern Denmark, will be interviewed.

Data on type 1 diabetes (n=5330) are matched on the same criteria bar the diagnosis, and in this process, for both cohorts, only when the diagnosis was registered during the period 1977-79.

Data and biological material

By drawing on data from several danish registers, we are able to examine in detail the prognoses and long-term outcomes of patients with schizophrenia in terms of the extent of contacts to the healthcare system, socio-economic situation as well as co-morbidity, causes of death and use of medicine.

Registers that are used:

• The Danish National Patient Register
  
• The Danish Central Psychiatric Register
• Statistics Denmark
• The Danish Database of Prescription Medications
• The Danish National Mortality Statistics database

Apart from obtaining general information about health and social situation, the interviews are semi-structured  and based on internationally validated assessment tools as follows:

• PANSS-R, SF-36, MHRM, MINI (only partly), MoCA, GAF and Charlson Comorbidity Index.

Hereby assessing the current status of mental and physical health, quality of life, psycho-social functioning, cognition, addiction, use of medicine, social and economic status.

Collaborating researchers and departments

General Psychiatric Ward, Odense University Hospital

• Professor and Consultant Kjeld Andersen, PhD, MSc
• Research Professor and consultant Bent Nielsen, PhD

OPEN Odense Patient data Explorative Network, Odense University Hospital

• Professor and consultant Anders Green, PhD, DMSc