Why Do People With Schizophrenia Die Early?

People with schizophrenia and bipolar disorder have a life expectancy of about 25 years shorter than the general public. Heart disease is the most frequent cause of death for people with schizophrenia. Cancer and suicide also top the list.

My brother, who had schizophrenia, died suddenly at age 42 from a heart problem our family didn’t know he had. His death staggered me, not only because he died much too soon but because dying young on top of having a horrible brain illness that affects only one percent of the population seemed overly cruel. Shouldn’t the universe mete out suffering more equitably? I wish it were so.

Why do people with schizophrenia have a shorter life expectancy? Explanations vary. Some antipsychotic medications cause significant weight gain, which increases the risk of heart disease and diabetes. Interestingly, though, the mortality seems to be higher in those who do not take antipsychotic medication

Heavy smoking is common in people with serious mental illness, as are alcohol and substance use, and a sedentary lifestyle. Poor medical care, homelessness, poverty, social isolation and incarceration are other contributing factors.  

The suicide rate in people with schizophrenia is shockingly high—170 times higher than the general population. Suicide may be spurred by impaired thinking, psychosis or impulsivity and can happen without warning. In other cases, the negative symptoms of schizophrenia, such as an inability to feel enjoyment and a lack of motivation or sense of purpose, can cause hopelessness and despair.

Could other factors be the cause of premature death? Perhaps genetics can explain the diminished life expectancy. Research has uncovered that genes associated with schizophrenia are the same ones responsible for the immune system response. Could there be a link between the two? 

More research could uncover better answers as to why people with schizophrenia die earlier. As a country, we need to invest much more in finding the causes of schizophrenia and better treatments. 

Research into serious mental illness is underfunded and underprioritized. In 2019, the National Institutes of Health spent $455 million on serious mental illness research compared to $3.3 billion on mental health research. Shouldn’t we spend more on research for the most severe illnesses rather than on mental health and wellness? 

This lack of research is a slap in the face to those with mental illness and their families who have experienced untold suffering. It also defies logic. The costs of untreated serious mental illness are astronomical, with a conservative estimate of $317 billion. Psychiatric disorders are the number one cause of disability. Untreated or undertreated, they lead to homelessness, incarceration and tragedy. 

We desperately need better treatments. The current treatments, which are limited to antipsychotics, are not adequate—not even close. While these medications can make a tremendous difference for many—eliminating delusions and disordered thinking—they do not work for everybody, and they do nothing to address the “negative” symptoms of schizophrenia, such as loss of interest in life and lack of motivation. 

They also have troubling side effects for many, such as weight gain, involuntary movements, breast development and drowsiness. Furthermore, they don’t address the root causes of schizophrenia—they only treat the symptoms.

We need to do better for our most vulnerable. Every person with mental illness is someone’s son or daughter, or sibling. They are human beings whose lives have value. It is cruel and immoral for society to brush them off. 

Schizophrenia is a brain illness. And if we can invest in research that results in better treatment, more people can recover and live meaningful, long and productive lives.

Advocacy Alert: According to the Treatment Advocacy Center, you can urge NIMH to prioritize serious mental illness research by submitting a public comment on the NIMH 2020–2025 Strategic Plan before February 2, 2021. To comment, email karen.gavin-evans@nih.gov with the subject line “NIMH Must Prioritize SMI Research.” Learn more at Treatment Advocacy Center.