---
title: "Antipsychotic Treatment Patterns and Mortality in Schizophrenia: Large Chinese Registry Cohort"
id: "pubmed-42548073"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42548073"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42548073/"
doi: "10.1017/S204579602610078X"
published_at: "2026-08-04T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Antipsychotic Treatment Patterns and Mortality in Schizophrenia: Large Chinese Registry Cohort
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42548073
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42548073/)
- **DOI:** [10.1017/S204579602610078X](https://doi.org/10.1017%2FS204579602610078X)
- **Published At:** 2026-08-04T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This population-based registry cohort from Guangdong Province, China, included 435,816 adults with schizophrenia and used the Community Schizophrenia Registry System as the data source. - Median follow-up was 7.2 years, during which 73,527 deaths (16.9%) occurred. - Patients were categorized into four treatment groups: **antipsychotic monotherapy**, **antipsychotic polytherapy**, non-antipsychotic treatment and non-drug treatment. - **Antipsychotic polytherapy** was the most common regimen (57.6%), followed by monotherapy (27.6%). - Compared with the non-drug group, adjusted hazard ratios (aHRs) for all-cause mortality were lower for polytherapy (aHR 0.18, 95% CI 0.18–0.19), monotherapy (aHR 0.24, 95% CI 0.24–0.25) and non-antipsychotic treatment (aHR 0.22, 95% CI 0.21–0.23). - Both **first- and second-generation antipsychotics** showed comparable associations with reduced mortality in this cohort. - Most polytherapy combinations performed similarly to or better than monotherapy, but particular combinations such as **risperidone–sulpiride** were linked with higher mortality. - Subgroup analyses indicated stronger mortality benefits associated with antipsychotic treatment among women, younger patients, rural residents and those with less severe illness. - Cox proportional hazards models were used to estimate adjusted hazard ratios; registry design and large sample size enabled real-world assessment in a non-Western population. - The study concludes that antipsychotic treatment is associated with substantially reduced all-cause **mortality** in people with schizophrenia in China, with variation by patient characteristics and specific regimens.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China. * 2 Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China. * 3 School of Public Health, Southern Medical University, Guangzhou, China. * PMID: **42548073** * DOI: [ 10.1017/S204579602610078X ](https://doi.org/10.1017/s204579602610078x) Item in Clipboard # Real-world antipsychotic prescribing patterns and mortality in schizophrenia: a registry cohort study from China Hongbo He et al. Epidemiol Psychiatr Sci. 2026. Show details Display options Display options Format Abstract PubMed PMID Epidemiol Psychiatr Sci Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Epidemiol+Psychiatr+Sci%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Epidemiol+Psychiatr+Sci%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42548073/) . 2026 Aug 4:35:e46. doi: 10.1017/S204579602610078X. ### Authors [Hongbo He](https://pubmed.ncbi.nlm.nih.gov/?term=He+H&cauthor_id=42548073)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42548073/#short-view-affiliation-1 "Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China."), [Lingyan Dai](https://pubmed.ncbi.nlm.nih.gov/?term=Dai+L&cauthor_id=42548073)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42548073/#short-view-affiliation-2 "Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China."), [Sicong Ma](https://pubmed.ncbi.nlm.nih.gov/?term=Ma+S&cauthor_id=42548073)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42548073/#short-view-affiliation-3 "School of Public Health, Southern Medical University, Guangzhou, China."), [Fu-Jun Jia](https://pubmed.ncbi.nlm.nih.gov/?term=Jia+FJ&cauthor_id=42548073)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42548073/#short-view-affiliation-1 "Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China."), [Bin Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+B&cauthor_id=42548073)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42548073/#short-view-affiliation-2 "Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China."), [Haicheng Lin](https://pubmed.ncbi.nlm.nih.gov/?term=Lin+H&cauthor_id=42548073)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42548073/#short-view-affiliation-1 "Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China."), [Shi-Bin Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+SB&cauthor_id=42548073)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42548073/#short-view-affiliation-1 "Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China."), [Wenyan Tan](https://pubmed.ncbi.nlm.nih.gov/?term=Tan+W&cauthor_id=42548073)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42548073/#short-view-affiliation-1 "Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China."), [Jie Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+J&cauthor_id=42548073)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42548073/#short-view-affiliation-2 "Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.") ### Affiliations * 1 Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China. * 2 Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China. * 3 School of Public Health, Southern Medical University, Guangzhou, China. * PMID: **42548073** * DOI: [ 10.1017/S204579602610078X ](https://doi.org/10.1017/s204579602610078x) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Aims:** Schizophrenia is a chronic psychiatric disorder associated with significantly elevated mortality. While antipsychotics are the cornerstone of treatment, their long-term effects on survival remain uncertain, particularly in non-Western populations. We aimed to assess the real-world association between antipsychotic treatment patterns and all-cause mortality among adults with schizophrenia in China. **Methods:** This population-based cohort study included 435,816 adults from the Community Schizophrenia Registry System of Guangdong Province, China. Patients were classified into four groups: antipsychotic monotherapy, polytherapy, non-antipsychotic treatment and non-drug treatment. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for mortality. **Results:** Over a median follow-up of 7.2 years, 73,527 deaths (16.9%) occurred. Antipsychotic polytherapy (57.6%) was the most common regimen, followed by monotherapy (27.6%). Compared with the non-drug group, mortality risks were significantly lower for polytherapy (aHR: 0.18; 95% CI: 0.18-0.19), monotherapy (aHR: 0.24; 95% CI: 0.24-0.25) and non-antipsychotic treatment (aHR: 0.22; 95% CI: 0.21-0.23). Both first- and second-generation antipsychotics showed comparable mortality benefits. While most polytherapy regimens performed similarly to or better than monotherapy, combinations like risperidone-sulpiride were associated with higher mortality. Subgroup analyses showed stronger benefits in women, younger individuals, rural residents and those with less severe illness. **Conclusions:** Antipsychotic treatment is associated with significantly reduced mortality among patients with schizophrenia in China, with effects varying by patient characteristics and drug regimen. **Keywords:** China; antipsychotic agents; mortality; real-world; schizophrenia. 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