Physical Comorbidity and Causes of Death Among Schizophrenia Patients: A Retrospective Descriptive Study
PDF
Cite
Share
Request
Research
P: 103-109
March 2019

Physical Comorbidity and Causes of Death Among Schizophrenia Patients: A Retrospective Descriptive Study

Med J Bakirkoy 2019;15(1):103-109
1. Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, Psikiyatri Kliniği, İstanbul, Türkiye
2. Şanlıurfa Akçakale Devlet Hastanesi, Psikiyatri Kliniği, Şanlıurfa, Türkiye
No information available.
No information available
Received Date: 14.02.2019
Accepted Date: 05.03.2019
PDF
Cite
Share
Request

ABSTRACT

Objective:

Schizophrenia is a chronical disorder that commonly starts in younger ages, leads to disability and early death. From the onset of the disease, close follow-up for general medical condition is of vital importance in prevention of pysical illnesses and extention of the lifetime as well as psycological benefits. In our study, the determination of physical comorbidity and causes of death among schizophrenia patients who hospitalized for treatment in chronic psychiatry services was aimed.

Methods:

The files of 45 patients, hospitalized and treated at least five years in Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery chronic psychiatry services between January 2006 and January 2013, diagnosed as schizophrenia according to the diagnostic criteria of DSM IV-TR, who died while their treatment and follow-up continuing were scanned retrospectively. Physical comorbidity present in admission files were determined according to ICD 10 diagnosis system. The sociodemographical and clinical findings were recorded to the data scan form prepared by researchers. The approval was got from ethical committee of our hospital. The data were analyzed by using statistical methods.

Results:

The patient with a mean age of death was 58.8±9.2 (range= 39-76). In 28.9% (n=13), there was falling story. The most common seen physical illnesses were; in 37.8% (n=17) chronic obstructive lung disease, in 33.3% (n=15) hypertension, in 17.8% (n=8) stroke and in 17.8% (n=8) coronary artery disease. It is determined that 48.9% (n=22) of the patients died because of circulating system disorders, 33.3% (n=15) died because of respiratory system disorders and 13.3% (n=6) died because of falling and secondary to trauma.

Discussion:

According to our findings, schizophrenia patients hospitalized and treated in chronic psychiatry services die at earlier ages than general population. Physical comorbidity and risk of fall trauma are high. The most common causes of death are circulating and respiratory system disorders. Results should be supported with prospective and comparative studies having more population numbers.

Keywords:
Schizophrenia, chronic psychiatry service, physical comorbidity, causes of death

References

1
Jablensky A. Schizophrenia: recent epidemiologic issues. Epidemiol Rev 1995;17:10-20.
2
Azad MC, Shoesmith WD, Al Mamun M, Abdullah AF, Naing DK, Phanindranath M, et al. Cardiovascular diseases among patients with schizophrenia. Asian J Psychiatr 2016;19:28-36.
3
Laursen TM, Munk-Olsen T, Vestergaard M. Life expectancy and cardiovascular mortality in persons with schizophrenia. Curr Opin Psychiatry 2012;25:83-8.
4
Dickerson F, Stallings C, Origoni A, Schroeder J, Khushalani S, Yolken R. Mortality in schizophrenia: clinical and serological predictors. Schizophr Bull 2014;40:796-803.
5
Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Arch Gen Psychiatry 2007;64:1123-31.
6
Songur E, Karslıoğlu EH, Soygür H, Kaymak SU, Özalp E, Cankurtaran EŞ. Şizofreni ve Şizoaffektif Bozuklukta Metabolik Sendrom. Klinik Psikiyatri 2012;15:80-91.
7
Döngel BD, Demirkol ME, Tamam L. Şizofreni hastalarında fiziksel hastalık eş tanılarının değerlendirilmesi Çukurova Med J 2018;43:892-902.
8
McEvoy JP, Meyer JM, Goff DC, Nasrallah HA, Davis SM, Sullivan L, et al. Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 2005;80:19-32.
9
Newcomer JW. Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs 2005;19(Suppl 1):1-93.
10
Newcomer JW, Meyer JM, Baker RA, Eudicone JM, Pikalov A, Vester-Blokland E, et al. Changes in non-high-density lipoprotein cholesterol levels and triglyceride/high-density lipoprotein cholesterol ratios among patients randomized to aripiprazole versus olanzapine. Schizophrenia Research 2008;106:300-7.
11
Weinmann S, Read J, Aderhold V. Influence of antipsychotics on mortality in schizophrenia: systematic review. Schizophr Res 2009;113:1-11.
12
McNamee L, Mead G, MacGillivray S, Lawrie SM. Schizophrenia, poor physical health and physical activity: evidence-based interventions are required to reduce major health inequalities. Br J Psychiatry 2013;203:239-41.
13
Lawrence D, Kisely S. Inequalities in healthcare provision for people with severe mental illness. J Psychopharmacol 2010;24(4 Suppl):61-8.
14
Köroğlu E. (DSM-IV-TR) Ruhsal Bozuklukların Tanısal ve Sayımsal Elkitabı, Yeniden Gözden Geçirilmiş Tam Metin. Ankara: Hekimler Yayın Birliği, 2007.
15
World Health Organization. International classification of diseases, tenth revision. Geneva, Switzerland: World Health Organization; 2007. http:// www.who.int/classifications/icd/en/
16
Türkiye İstatistik Kurumu. Temel istatistikler, Nüfus ve Demografi, Nüfus Projeksiyonları, Yaş grubu ve cinsiyete göre nüfus, www.tuik.gov.tr
17
Bitter I, Czobor P, Borsi A, Fehér L, Nagy BZ, Bacskai M, et al. Mortality and the relationship of somatic comorbidities to mortality in schizophrenia. A nationwide matched-cohort study. Eur Psychiatry 2017;45:97-103.
18
Lawrence D, Hancock KJ, Kisely S. The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population based registers. BMJ 2013;346:2539.
19
19.Tanskanen A, Tiihonen J, Taipale H. Mortality in schizophrenia: 30-year nationwide follow-up study. Acta Psychiatr Scand 2018;138:492-9.
20
Crump C, Winkleby MA, Sundquist K, Sundquist J. Comorbidities and mortality in persons with schizophrenia: a Swedish national cohort study. Am J Psychiatry 2013;170:324-33.
21
Karşıdağ Ç, Aksoy UM, Yüksel G, Alpay N, Uysal A. Yataklı tedavi hizmeti sunan psikiyatri kliniklerinde ek tanılar. Klinik Psikiyatri 2013;16:47-52.
22
Gur S, Weizman S, Stubbs B, Matalon A, Meyerovitch J, Hermesh H, et al. Mortality, morbidity and medical resources utilization of patients with schizophrenia: A case-control community-based study. Psychiatry Res 2018;260:177-81.
23
Piotrowski P, Gondek TM, Królicka-Deręgowska A, Misiak B, Adamowski T, Kiejna A. Causes of mortality in schizophrenia: An updated review of European studies. Psychiatr Danub 2017;29:108-20.
24
Shafie S, Lee SP, Ong SBC, Wang P, Seow E, Ong HL, et al. Prevalence and correlates of diabetes mellitus and dyslipidaemia in a long-stay inpatient schizophrenia population in Singapore. Singapore Med J 2018;59:465-71.
25
Leucht S, Burkard T, Henderson J, Maj M, Sartorius N. Physical illness and schizophrenia: a review of the literature. Acta Psychiatr Scand 2007;116:317-33.
26
Bermudes RA, Keck PE, McElroy SL. Psikiyatrik hastalığı olanlarda metabolik anormalliklerle başaçıkabilme. Psikiyatristler için klinik rehber. İçinde: Karamustafalıoğlu O. 1.Baskı, İstanbul: Sigma Publishing, 2008:25-53.
27
APA: Practice guideline for the treatment of patients with schizophrenia, 2nd ed. Arlington: VA. 2004.
28
Aso K, Okamura H. Association between Falls and Balance among Inpatients with Schizophrenia: A Preliminary Prospective Cohort Study. Psychiatr Q 2018.
29
Tsuji Y, Akezaki Y, Mori K, Yuri Y, Katsumura H, Hara T, et al. Factors inducing falling in schizophrenia patients. J Phys Ther Sci 2017;29:448-51.
30
Lavsa SM, Fabian TJ, Saul MI, Corman SL, Coley KC. Influence of medications and diagnoses on fall risk in psychiatric inpatients. Am J Health Syst Pharm 2010;67:1274-80.
31
Mackin P. Cardiac side effects of psychiatric drugs. Hum Psychopharmacol 2008;23(Suppl 1):3-14.
32
Loas G, Azi A, Noisette C, Yon V. [Mortality among chronic schizophrenic patients: a prospective 14-year follow-up study of 150 schizophrenic patients]. Encephale 2008;34:54-60.
33
Li KJ, Gurrera RJ, Delisi LE. Potentially fatal outcomes associated with clozapine. Schizophr Res 2018;199:386-9.
34
Chou FH, Tsai KY, Wu HC, Shen SP. Cancer in patients with schizophrenia: What is the next step? Psychiatry Clin Neurosci 2016;70:473-88.