Psychological illnesses can increase the risk of physical health issues, such as high blood pressure and heart disease. Individuals diagnosed with schizophrenia often have comorbid health conditions that can decrease quality of life and even lead to premature death. In fact, smoking, drug use, and suicide are some of the factors that increase premature death in schizophrenia. But other less threatening, but equally disturbing, conditions may be present.
Additionally, life-threatening chronic issues like heart disease could be present and yet remain undiagnosed, further increasing the chance of early death. In an effort to explore the comorbidities common in schizophrenia and other psychoses, Daniel J. Smith of the Institute of Health and Wellbeing at the University of Glasgow in Scotland recently analyzed data from 9,677 adults with schizophrenia and compared their comorbidities to those found in over 1.4 million individuals without schizophrenia.
Smith found that the three most common comorbid illnesses in the participants with schizophrenia were constipation, viral hepatitis, and Parkinson’s disease. Constipation is a common side effect of antipsychotic medication and could perhaps explain the high rates of this condition in the those who had schizophrenia. Likewise, Parkinson’s disease and tremors are also medication related issues that might explain the high prevalence in the schizophrenic participants compared to the control sample. Smith believes that viral hepatitis could be the result of drug use, a common behavior in people with psychosis.
Surprisingly, Smith found that the rates of cardiovascular disease were lower in the participants with schizophrenia than in the controls. Although high blood pressure was another common issue found in those with schizophrenia, Smith believes that heart disease, a condition found to be common in other studies on schizophrenia comorbidity, may be underdiagnosed or overlooked in many with psychosis.
Smith added that people with mental health conditions often think their physical health is being adequately monitored by mental health providers, and therefore do not seek out primary care help for issues. This could lead to less identification of serious health issues like heart disease. Smith said, “This suggests a systematic under-recognition and under-treatment of cardiovascular disease in people with schizophrenia, which might contribute to substantial premature mortality observed within this patient group.” Future research should focus on reporting mechanisms and the consistency of primary care treatment in the schizophrenic population.
Smith, D.J., Langan, J., McLean, G., et al. (2013). Schizophrenia is associated with excess multiple physical health comorbidities but low levels of recorded cardiovascular disease in primary care: Cross-sectional study. BMJ Open 2013;3: e002808. doi:10.1136/bmjopen-2013-002808
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