title: Medical morbidity and mortality in schizophrenia: guidelines for psychiatrists.
abstract: BACKGROUND
  Medical morbidity and mortality rates remain elevated in schizophrenia patients compared with the general population, in part due to potentially reversible medical risk factors. Psychiatrists should address this problem by adopting established strategies for prevention and intervention.
  
  
  METHODS
  The literature on modifiable medical risk factors relevant to individuals with schizophrenia and corresponding guidelines for prevention and treatment established by expert consensus panels were reviewed.
  
  
  RESULTS
  Schizophrenia patients are at elevated risk for cardiovascular disease due to high rates of cigarette smoking and, increasingly, due to obesity, diabetes, and hypertriglyceridemia. Rates of human immunodeficiency virus infection and infectious hepatitis are also higher in schizophrenia patients. Interventions that have reduced medical morbidity in the general population can be adopted to reduce premature mortality in individuals with schizophrenia.
  
  
  CONCLUSIONS
  Patients with schizophrenia have high rates of potentially reversible medical morbidity. Implementation of practice guidelines for identifying and modifying risk factors could substantially improve the health of patients with schizophrenia.
authors.affiliation: Schizophrenia Program, Massachusetts General Hospital, Boston, MA 02114, USA. goff@psych.mgh.harvard.edu
authors.forename: Donald C
authors.initials: DC
authors.lastname: Goff
authors.forename: Corinne
authors.initials: C
authors.lastname: Cather
authors.forename: A Eden
authors.initials: AE
authors.lastname: Evins
authors.forename: David C
authors.initials: DC
authors.lastname: Henderson
authors.forename: Oliver
authors.initials: O
authors.lastname: Freudenreich
authors.forename: Paul M
authors.initials: PM
authors.lastname: Copeland
authors.forename: Michael
authors.initials: M
authors.lastname: Bierer
authors.forename: Kenneth
authors.initials: K
authors.lastname: Duckworth
authors.forename: Frank M
authors.initials: FM
authors.lastname: Sacks
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D002423:Cause of Death; D003141:Communicable Diseases / Q000453:epidemiology / Q000401:mortality; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D006973:Hypertension / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009765:Obesity / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000379:methods; D011570:Psychiatry / Q000379:methods / Q000592:standards*; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology* / Q000401:mortality*; D012907:Smoking / Q000453:epidemiology / Q000401:mortality; D016540:Smoking Cessation; D000074606:Smoking Prevention