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Is Cardiovascular Disease Being Overlooked in People with Schizophrenia?

 

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.

Reference:
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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Comments
  • Ludwig June 24th, 2013 at 10:23 AM #1

    If it is being overlooked then I can kind of understand it. There are probably many providers who get tunnel vision and treat the most apparent problem and don’t think about the physical issues that could be lurking within the patient too. Kind of sad but hopefully this alone would encourage more people to keep in regular tough with their physician to make sure that every potential thing is being monitired carefully.

  • Andrew June 24th, 2013 at 11:59 PM #2

    Hmm…this could be common,but is very dangerous…any issue that is ignored or undiagnosed can quickly turn into something very dangerous.

    Maybe they should have regular monitoring for these people…because they may not even be able to stick to a regular health check up schedule due to their commitments with medication and other things…!

  • Jean June 25th, 2013 at 4:15 AM #3

    Any of us who has had a family member with a severe mental illness knows that there is a great deal of importance in notifying each doctor that they see about the diagnoses and suggestions of the other physicians, as well as medications and concerns. Sometimes it can all get a little daunting so I suggest making notes and lists of questions that you have and take those along with you to appointments so that you don’t forget about something that you wanted to ask. It can be a little overwhelming receiving information from many different medical professionals, but if you make your concerns known then I think that there is a much better chance that the patient will get better treatment.

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