Schizophrenia is associated with excess multiple physical-health comorbidities but low levels of recorded cardiovascular disease in primary care: cross-sectional study

Abstract

ObjectiveTo assess the nature and extent of physical-health comorbidities in people with schizophrenia and related psychoses compared with controls.DesignCross-sectional study.Setting314 primary care practices in Scotland.Participants9677 people with a primary care record of schizophrenia or a related psychosis and 1 414 701 controls. Main outcome measures Primary care records of 32 common chronic physical-health conditions and combinations of one, two and three or more physical-health comorbidities adjusted for age, gender and deprivation status.ResultsCompared with controls, people with schizophrenia were significantly more likely to have one physical-health comorbidity (OR 1.21, 95% CI 1.16 to 1.27), two physical-health comorbidities (OR 1.37, 95% CI 1.29 to 1.44) and three or more physical-health comorbidities (OR 1.19, 95% CI 1.12 to 1.27). Rates were highest for viral hepatitis (OR 3.98, 95% CI 2.81 to 5.64), constipation (OR 3.24, 95% CI 3.00 to 4.49) and Parkinson's disease (OR 3.07, 95% CI 2.42 to 3.88) but people with schizophrenia had lower recorded rates of cardiovascular disease, including atrial fibrillation (OR 0.62, 95% CI 0.51 to 0.73), hypertension (OR 0.71, 95% CI 0.67 to 0.76), coronary heart disease (OR 0.75, 95% CI 0.61 to 0.71) and peripheral vascular disease (OR 0.83, 95% CI 0.71 to 0.97).ConclusionsPeople with schizophrenia have a wide range of comorbid and multiple physical-health conditions but are less likely than people without schizophrenia to have a primary care record of cardiovascular disease. This suggests a systematic under-recognition and undertreatment of cardiovascular disease in people with schizophrenia, which might contribute to substantial premature mortality observed within this patient group.

Comorbidity and polypharmacy in people with dementia: insights from a large, population-based cross-sectional analysis of primary care data

“…This paper examines a large population sample of people aged 65 years and over, examining prevalence of physical co-morbidity and polypharmacy in people with and without dementia. We have used similar methods to explore comorbidity and polypharmacy in schizophrenia [13] and bipolar disorder [14] in the same population dataset. Parkinson's Disease, and unspecified dementia .…”

Medical Co-Morbidity in Schizophrenia from Rural Region of Central India: A Cross-Sectional Study

“…Our findings are consistent with a study conducted by Smith DJ et al who reported that people with schizophrenia had lower recorded rates of cardiovascular disease as compared to other physical health co morbidities. 23 The variation as compared to other studies can be accounted to the fact of difference in sample demographics like variations in setting, as our study was on rural population. It is a well-known fact that both typical and atypical antipsychotics though are main stay of treatment for schizophrenia, are also associated with their side effects.…”

Parkinson’s disease psychosis

“…A recent cross-sectional study examined frequency of comorbidities diagnosed in patients with schizophrenia. 32 It found that, compared to control individuals, people with schizophrenia were more likely to have PD as a comorbidity with an OR of 3.07 (95% CI, 2.42-3.88). Given the limitations of the study design, the nature of this relationship remains difficult to describe.…”