Long-term follow-up of all-cause and unnatural death in young people with first-episode psychosis

Objective: To determine mortality-related estimates and causes of death in young people with first-episode psychosis (FEP), and to identify baseline predictors of mortality. Method: Mortality outcomes in 723 young people presenting to an early psychosis service were prospectively ascertained up to 20. years. Predictors of all-cause and unnatural death were investigated using survival techniques. Results: Forty-nine participants died by study end. Most deaths (n. =. 41) occurred within 10. years of service entry. All-cause mortality was 5.5% at 10. years, rising to 8.0% after 20. years. Unnatural death rates at 10 and 20. years were 5.0% and 5.9%, respectively. Three risk factors consistently predicted all-cause mortality and unnatural deaths. Conclusion: A substantial proportion of excess mortality was due to non-suicide unnatural death, and, later, natural deaths. This suggests that mental health services should expand their current focus on suicide to incorporate strategies to prevent accidental death and promote healthier lifestyles.