To study gender differences in mortality among patients with schizophrenia over a period of 27 years.

A longitudinal psychiatric admission register in Northern Norway linked to the National Norwegian Cause of Death Register.

1111 patients with schizophrenia admitted from 1980 – 2006.

Weconfirm the persisting mortality gap between patients with schizophrenia and the general population over a period of 27 years, with a tendency of increasing standardized mortality rates. Male and female schizophrenic patients had 3.5 (95% CI: 3.1 to 4.1) and 2.6 (95% CI: 2.1 to 3.2) times higher mortality, respectively (p = 0.01 for the difference between the genders). Age-adjusted mortality rates in female schizophrenic patients admitted for the first time after 1992 was 70% higher than for those admitted previously, and female patients admitted for the first time after 1992 had significantly higher SMRs (4.6, 95% CI: 2.9 to 7.2) than women who were admitted earlier (SMR = 2.4, 95% CI: 1.9 to 2.9) (p = 0.009). Thus, the absolute mortality also increased. The SMRs for women admitted after 1992 are higher than for men. Men who had always been admitted voluntarily had non-significantly lower mortality than women in the same situation, while for women there was a linear, statistically significant trend towards higher SMRs for women with less use of coercion.

There is a persisting mortality gap between patients with schizophrenia and the general population over a period of 27 years.