Excess mortality in patients with schizophrenia spectrum disorders in Malaga (Spain): A cohort study.

AIMS: There is evidence that patients with schizophrenia spectrum disorders present higher mortality in comparison with the general population. The aim of this study was to analyse the causes of mortality and sociodemographic factors associated with mortality, standardised mortality ratios (SMRs), life expectancy and potential years of life lost (YLL) in patients with schizophrenia spectrum disorders in Spain. METHODS: The study included a cohort of patients from the Malaga Schizophrenia Case Register (1418 patients; 907 males; average age 42.31 years) who were followed up for a minimum of 10 years (median = 13.43). The factors associated with mortality were analysed with a survival analysis using Cox's proportional hazards regression model. RESULTS: The main causes of mortality in the cohort were circulatory disease (21.45%), cancer (17.09%) and suicide (13.09%). The SMR of the cohort was more than threefold that of the population of Malaga (3.19). The life expectancy at birth was 67.11 years old, which is more than 13 years shorter than that of the population of Malaga. The YLL was 20.74. The variables associated with a higher risk of mortality were age [adjusted hazard ratio (AHR) = 1.069, p < 0.001], male gender (AHR = 1.751, p < 0.001) and type of area of residence (p = 0.028; deprived urban zone v. non-deprived urban area, AHR = 1.460, p = 0.028). In addition, receiving welfare benefit status in comparison with employed status (AHR = 1.940, p = 0.008) was associated with increased mortality. CONCLUSIONS: There is excess mortality in patients with schizophrenia spectrum disorders and also an association with age, gender, socioeconomic inequalities and receiving welfare benefits. Efforts directed towards improved living conditions could have a positive effect on reducing mortality.

Accidentes laborales en la provincia de Málaga. Participación del alcohol etílico y las drogas de abuso / Labor accidents in the province of Malaga. Participation of the ethyl alcohol and the drugs of abuse

El presente trabajo se corresponde con un estudio observacional descriptivo de los accidentes de trabajo ocurrido en la provincia de Málaga entre Octubre de 2003 y Diciembre de 2006, con resultado de muerte y que fueron autopsiados en el Instituto de Medicina Legal de Málaga. En él hemos analizado todas aquellas variables circunstanciales que, de una forma u otra, desempeñan algún papel en la etiopatogenia de este tipo de lesiones, haciendo hincapié en la participación del alcohol etílico y las drogas de abuso. Se describen 17 casos positivos a alcohol etílico, cannabis o cocaína y destácala ausencia de medidas de seguridad en el trabajador. Todo ello con la finalidad de establecer unas pautas de conducta que permitan, en la medida de lo posible, ayudar a prevenir e incluso a disminuir el número de estos accidentes que, por desgracia, en pleno siglo XXI se vienen cobrando todos los años un número no desechable de vidas humanas, con la tragedia que ello supone (AU)

This work corresponds to a descriptive observational study of work accidents occurred in the province of Malaga between October 2003 and December 2006, resulting in death and which were autopsied in the Institute of Legal Medicine of Malaga. We have analyzed all those circumstantial variables that, in one way or another, play a role in the pathogenesis of these lesions, emphasizing in the participation of ethyl alcohol and drug abuse. We described 17 cases positive to ethylic alcohol, cannabis or cocaine and the absence of safety measures in the worker. All this with the purpose of establishing a few behavior guidelines which as far as possible, may help to anticipate, and even to diminish the number of this type of accidents that, unfortunately, in full 21stcentury are still very high (AU)