Medical morbidity and mortality in schizophrenia: guidelines for psychiatrists.
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.
Goff
Donald C
DC
Schizophrenia Program, Massachusetts General Hospital, Boston, MA 02114, USA. goff@psych.mgh.harvard.edu
Cather
Corinne
C
Evins
A Eden
AE
Henderson
David C
DC
Freudenreich
Oliver
O
Copeland
Paul M
PM
Bierer
Michael
M
Duckworth
Kenneth
K
Sacks
Frank M
FM
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