Premature Mortality and Schizophrenia—The Need to Heal Right From the Start

To the Editor Using a retrospective Medicaid database, Olfson et al¹ reported an alarming 3.5-fold increased and growing mortality risk in people with schizophrenia. Standardized mortality ratios were particularly high for cardiovascular illness and smoking- and substance use–related mortality causes. One acknowledged relevant limitation of this study, and all database studies, was lacking information on established risk factors. While the assessment of diet and exercise is not part of usual care, data on smoking, weight, and glucose and lipid levels are available, collected (albeit still far too incompletely) and available in patient medical records. There is an enormous need and opportunity to include this crucial information as part of insurance and other large databases.