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Abstract

第117巻第10号

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Deceased Schizophrenic Patients -Focus on QT Prolongation-
Kimiko MATSUDA1, Koji KASE1, Koichiro HARA2, Yoshiyuki ASAI2, Kuniya ASAI4, Shotaro SAKURAI5, Tetsuro YUMOTO5, Kohzo TAKAYAMA5, Takehiko SHUNO2,3
1 Department of Pharmacy, Asai Hospital
2 Department of Psychiatry, Asai Hospital
3 Department of Internal Medicine, Asai Hospital
4 Department of Cardiology, Nippon Medical School Chiba Hokuso Hospital
5 School of Pharmaceutical Sciences, Hoshi University
Psychiatria et Neurologia Japonica 117: 826-836, 2015
Accepted in revised form: 15 April 2015.

 We retrospectively evaluated factors affecting the lifespan of schizophrenic patients, who are known to have a shorter life expectancy than healthy people, focusing on the relationship with QT prolongation associated with antipsychotics.
 In a total of 406 patients who died at Asai Hospital the mean age at death was compared between schizophrenic patients and nonpsychiatric patients. In deceased schizophrenic patients, drug-related factors, hematology results, and electrocardiographic findings for 3 years before death were compared with those for the same period in age-matched surviving schizophrenic patients. In addition, QT values in schizophrenic patients and healthy controls were evaluated by age group.
 The mean age at death was significantly younger in schizophrenic patients (63.4±2.63 years) than in nonpsychiatric patients (84.0±0.57 years) (p<0.001). Bivariate analysis between deceased and surviving schizophrenic patients showed significant differences in QT values at 2 years, 1 year, and 0.5 years before death and in AST and ALT values at 0.5 years before death. The incidence of QT prolongation in deceased schizophrenic patients (52.0%) was about twice as high as that in surviving schizophrenic patients (24.5%). Multiple logistic regression analysis suggested that the proportion of deceased patients was higher when QT intervals were longer and ALT values were relatively higher, even if within the normal range. In both schizophrenic patients and medical checkup examinees, QT values were positively correlated with the age (R2=0.9061 and 0.9276, respectively), and QT intervals in schizophrenic patients were significantly longer in the 30- to 70-year age groups.
 In both schizophrenic patients and medical checkup examinees, QT values were positively correlated with the age, and QT intervals in schizophrenic patients were significantly longer than those in medical checkup examinees in the same age groups. Deceased schizophrenic patients showed significantly longer QT intervals from 2 years before death than age-matched surviving schizophrenic patients. QT prolongation may influence the lifespan of schizophrenic patients, which are shorter than those of nonpsychiatric patients. This highlights the importance of following electrocardiographic findings and hematology results of schizophrenic patients over time.
 <Authors' abstract>

Keywords:Schizophrenia, QT prolongation, lifespan>
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