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The iHOPE-20 study: mortality in first episode psychosis—a 20-year follow-up of the Dublin first episode cohort

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Increased mortality rates have been found in those with a diagnosis of psychosis; studies suggest a shortened life expectancy of up to 20 years less than that of the general population. This study aimed to investigate the mortality of a first episode psychosis cohort at 20-year follow-up, compare it to that of the general Irish population, and explore whether the mortality gap has changed over time.


171 individuals diagnosed with a first episode psychosis identified between 1995 and 1999 in a community mental health service were traced. Mortality was established by matching death certificates to deceased cohort members (using name, age at date of death, and address at date of death). Date of first presentation to service was used as date of entry point and date of death or end of follow-up as the end point.


Of the 171 cases there were 20 deaths during follow-up. Nine deaths were attributed to natural causes; 7 to unnatural causes; and 4 were unknown. Comparing standardised mortality rates at 20-year follow-up to those at 12 year showed a reduction in rates over time.


Findings suggest that the mortality gap in people with schizophrenia and other psychoses remains high, especially in young males.

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Grant HRA_HSR/2013.409 awarded by the Health Research Board of Ireland.

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Correspondence to Roisin Doyle.

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The authors declare they have no conflict of interest.

Ethical statement

This study has been approved by the relevant and appropriate ethics committee and have, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Doyle, R., O’Keeffe, D., Hannigan, A. et al. The iHOPE-20 study: mortality in first episode psychosis—a 20-year follow-up of the Dublin first episode cohort. Soc Psychiatry Psychiatr Epidemiol 54, 1337–1342 (2019).

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