Consensus on physical health of patients with schizophrenia from the Spanish Societies of Psychiatry and Biological Psychiatry

Abstract

Introduction. Schizophrenia has traditionally been associated with higher rates of physical comorbidity and excess mortality. Objective. To develop a Spanish consensus document concerning the physical health of patients with schizophrenia and the interventions required to reduce the over-morbidity and over-mortality of these patients.

Method. The process consisted of: G) systematic review of the literature in the Medline database up to January 2006 and manual review of the bibliographical references of the papers obtained; b) reviews of national and international guides by the coordinating committee and medical specialist acting as expert advisors; e) multidisciplinary consensus meetings, and d) editing of the final consensus document.

Results. Compared to the general population, patients with schizophrenia present higher rates of infection (HBV, HCV, HIV), endocrine/metabolic disorders, cardiac and respiratory diseases (over-morbidity) and higher global death risk, as well as death from natural causes -basically respiratory, cardiovascular and oncological diseases (over-mortality)-. As a guide, therefore, this document proposes a series of interventions to be performed by psychiatrists to reduce the current rates.

Conclusions. Given the over-morbidity and over-mortality of patients with schizophrenia, awareness of these aspects should be increased among primary healthcare providers and specialists, including psychiatrists, and physical health problems should be incorporated into psycho-educational programs, and treatment compliance and severe mental disorder treatment units.