Unnatural death in Chinese patients with schizophrenia spectrum disorder: Age distribution, sex and seasonal patterns

Schizophr Res. 2026 Jul 27;297:37-45. doi: 10.1016/j.schres.2026.07.018. Online ahead of print.

ABSTRACT

BACKGROUND: Although excess mortality in schizophrenia spectrum disorders (SSD) is primarily attributable to natural causes, individuals with SSD have an increased risk of unnatural death compared with the general population. Previous research has focused mainly on suicide, whereas accidental deaths have received less attention. Age, sex, and season may influence unnatural death risk, but studies integrating these factors are limited. This study examined age-, sex-, and seasonal patterns of unnatural deaths in SSD.

METHODS: Using data from the Jiangsu Province Management Information System for Patients with Severe Mental Illness (SMI), unnatural deaths among individuals with SSD from 2014 to 2022 were included. Analysis examined cause distribution, age at death, and patterns by sex and season.

RESULTS: Among 4924 unnatural deaths (mean age 56.44 ± 16.97 years), suicide was the leading cause (22.9%), followed by drowning (20.9%), falls (20.5%), traffic accidents (15.4%), and other causes (20.4%). Mean age at death differed across causes, with suicide having the lowest mean age (49.43 ± 15.10 years) and falls the highest (65.38 ± 16.92 years). Females died at an older age than males and had higher proportions of drowning and falls, while males had higher proportions of traffic accidents. No significant sex difference was observed in suicide. The mean age at death was highest in winter. Suicide peaked in spring and autumn, falls peaked in winter, and drowning showed no significant seasonal variation.

CONCLUSION: Unnatural deaths among individuals with SSD vary by age, sex, and season. These findings may help inform targeted prevention strategies.

PMID:42508372 | DOI:10.1016/j.schres.2026.07.018