title: Comorbidity of hospital-treated psychiatric and physical disorders with special reference to schizophrenia: a 28 year follow-up of the 1966 northern Finland general population birth cohort.
abstract: We studied the comorbidity of psychiatric and physical disorders in a sample (n = 11,017) from the unselected, general population, Northern Finland 1966 Birth Cohort. During the period 1982-1994, hospital-treated psychiatric patients were more likely than people without psychiatric diagnoses to have been treated for physical disease in hospital wards, 298 out of 387 (77%) vs 6687 out of 10,630 (62.9%) (OR = 2.0, 95% CI = 1.6-2.5). Injuries, poisonings and indefinite symptoms were a more common reason for hospital treatment in people with schizophrenia or other psychiatric disorder as compared with people without a psychiatric disorder. Men with psychiatric disorder had more than a 50-fold risk for poisoning by psychotropic drugs (OR = 52.6, 95% CI = 27.7-99.8), women with psychiatric disorder a 20-fold risk (OR = 19.0, 95% CI = 9.5-38.1) and schizophrenics more than a 30-fold (OR = 37.5, 95% CI = 19.1-73.8). Men with psychiatric disorders were more commonly hospitalised for a variety of gastrointestinal disorders and circulatory diseases (OR = 2.3, 95% CI = 1.2-4.4), as compared with men with no psychiatric disorder. Respiratory diseases (OR = 2.2, 95% CI = 1.2-4.2, vertebral column disorders (OR = 4.2, 95% CI = 1.8-9.9), gynaecological disorders (OR = 2.1, 95% CI = 1.2-3.6) and induced abortions (OR = 1.8, 95% CI = 1.2-2.7) were more prevalent in women with psychiatric disorder than in other women. Epilepsy was strongly associated with schizophrenia (OR = 11.1, 95% CI = 4.0-31.6). Nervous and sensory organ diseases in general (OR = 2.5, 95% CI = 1.1-5.8) and inflammatory diseases of the bowel (OR = 12.8, 95% CI = 3.8-42.7) were also overrepresented in schizophrenia when compared with people without a psychiatric disorder. Our results indicate that physicians must be alert for psychiatric disorder, and mental health professionals must be aware of the considerable morbidity in their patients.
authors.affiliation: Department of Psychiatry, University of Oulu, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Mäkikyrö
authors.forename: J T
authors.initials: JT
authors.lastname: Karvonen
authors.forename: H
authors.initials: H
authors.lastname: Hakko
authors.forename: P
authors.initials: P
authors.lastname: Nieminen
authors.forename: M
authors.initials: M
authors.lastname: Joukamaa
authors.forename: M
authors.initials: M
authors.lastname: Isohanni
authors.forename: P
authors.initials: P
authors.lastname: Jones
authors.forename: M R
authors.initials: MR
authors.lastname: Järvelin
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D016017:Odds Ratio; D011446:Prospective Studies; D012559:Schizophrenia / Q000453:epidemiology; D012737:Sex Factors