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Release: March 22, 1999

UI study finds social support may increase longevity of people with schizophrenia

IOWA CITY, Iowa -- The social environment of people with schizophrenia, specifically the quantity of social support they receive, may affect how long they live, according to a University of Iowa study published in the March 22 issue of the journal Psychosomatic Medicine.

Alan J. Christensen, UI associate professor of psychology and the study's lead author, said the researchers found that patients with schizophrenia who had frequent social interaction lived on average 25 percent longer than patients who had little or no social interaction.

"The findings are consistent with other studies that show social factors are related to physical health and mortality in individuals with medical conditions such as cancer, heart disease or kidney disease," Christensen said. "We decided to look at this question in terms of a psychiatric population."

Christensen developed the idea for the study along with research team member Rachel A. Dornink, a first-year student at the UI College of Medicine. As a UI undergraduate in psychology, Dornink collected the project data as part of a senior honor thesis that Christensen supervised. Other UI investigators included Susan K. Schultz, M.D., assistant professor of psychiatry, and Shawna L. Ehlers, doctoral student in clinical psychology.

The researchers examined the medical records of 133 patients with schizophrenia who were admitted between 1934 and 1944 to the former Iowa Psychopathic Hospital. All of the patients, 67 men and 66 women, had died by the time the study began. The researchers assessed the quantity and quality of social resources available to the patients, such as the number of close relationships patients had and the quality of support provided by family or friends. The team checked the State of Iowa Death Registry to determine the date and cause of death for each individual. The study's survival rate analysis adjusted for each individual's age at time of admission.

"We found that the quantity of support significantly predicted the longevity of the patients," Christensen said. "The frequency of daily interactions with support providers or confidants seemed to make a difference in these people's lives."

Other studies have shown that social support contributes favorably to the body's immune system as well as cardiovascular and hormonal functions. The researchers also suggested that the greater longevity observed among patients with more frequent social interactions might be due to the fact that social connections can help a person reduce negative health behaviors such as smoking or substance abuse.

In contrast, the quality of social interactions, that is whether they were negative or positive, did not indicate longevity for patients with schizophrenia. That outcome is consistent with other studies of the general population, but the researchers also noted that this study's dependence on hospital records rather than firsthand interviews might have masked the multifaceted nature of social support. The study also showed that married patients lived somewhat longer than unmarried patients.

The causes of death in the patients with schizophrenia were similar to those found in the general population of that time period. For example, cardiovascular disease caused more than one-third of the deaths.

"The physical health of psychiatric patients has received relatively little attention from researchers," Christensen said. "The tendency has been to focus on the patients' psychiatric health, yet these individuals don't live as long as the general population. We hope the study is a step toward examining factors that influence the long-term physical health of patients with psychiatric disorders."

Schizophrenia commonly appears in the late teens or early 20s. People with the condition may have psychotic symptoms such as delusions or hallucinations. Their relationships and careers often deteriorate, and the person becomes alienated from others, resulting in increased social isolation and a loss of social support. Patients with schizophrenia may also be less likely to seek and receive needed medical care, Christensen said.

He added that it will be important to examine whether social support interventions can have a positive effect on the health of people with schizophrenia.

Psychosomatic Medicine is the journal of the American Psychosomatic Society. The UI study was published under the title "Social Environment and Longevity in Schizophrenia."