Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care.
BACKGROUND
Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their physical problems; however GPs have neither specific management policies nor guidelines for the diagnosis and treatment of somatic co-morbidity in schizophrenia patients. This paper systematically reviews the prevalence and treatment of somatic co-morbidity in schizophrenia patients in general practice.


METHODS
The MEDLINE, EMBASE, PsycINFO data-bases and the Cochrane Library were searched and original research articles on somatic diseases of schizophrenia patients and their treatment in the primary care setting were selected.


RESULTS
The results of this search show that the incidence of a wide range of diseases, such as diabetes mellitus, the metabolic syndrome, coronary heart diseases, and COPD is significantly higher in schizophrenia patients than in the normal population. The health of schizophrenic patients is less than optimal in several areas, partly due to their inadequate help-seeking behaviour. Current GP management of such patients appears not to take this fact into account. However, when schizophrenic patients seek the GP's help, they value the care provided.


CONCLUSIONS
Schizophrenia patients are at risk of undetected somatic co-morbidity. They present physical complaints at a late, more serious stage. GPs should take this into account by adopting proactive behaviour. The development of a set of guidelines with a clear description of the GP's responsibilities would facilitate the desired changes in the management of somatic diseases in these patients.
Department of General Practice, University Medical Centre Groningen, University of Groningen, Antonius Deusinglaan 1, 9713AV Groningen, The Netherlands. m.j.t.oud@home.nl
Marian J T
MJ
Oud
Betty
B
Meyboom-de Jong
D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000628:therapy; D002908:Chronic Disease / Q000453:epidemiology* / Q000628:therapy*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy; D005194:Family Practice / Q000379:methods*; D006801:Humans; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000628:therapy; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000628:therapy; D012559:Schizophrenia / Q000453:epidemiology* / Q000628:therapy*