title: Schizophrenia is associated with excess multiple physical-health comorbidities but low levels of recorded cardiovascular disease in primary care: cross-sectional study.
abstract: OBJECTIVE
  To assess the nature and extent of physical-health comorbidities in people with schizophrenia and related psychoses compared with controls.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  314 primary care practices in Scotland.
  
  
  METHODS
  9677 people with a primary care record of schizophrenia or a related psychosis and 1 414 701 controls. Main outcome measures Primary care records of 32 common chronic physical-health conditions and combinations of one, two and three or more physical-health comorbidities adjusted for age, gender and deprivation status.
  
  
  RESULTS
  Compared with controls, people with schizophrenia were significantly more likely to have one physical-health comorbidity (OR 1.21, 95% CI 1.16 to 1.27), two physical-health comorbidities (OR 1.37, 95% CI 1.29 to 1.44) and three or more physical-health comorbidities (OR 1.19, 95% CI 1.12 to 1.27). Rates were highest for viral hepatitis (OR 3.98, 95% CI 2.81 to 5.64), constipation (OR 3.24, 95% CI 3.00 to 4.49) and Parkinson's disease (OR 3.07, 95% CI 2.42 to 3.88) but people with schizophrenia had lower recorded rates of cardiovascular disease, including atrial fibrillation (OR 0.62, 95% CI 0.51 to 0.73), hypertension (OR 0.71, 95% CI 0.67 to 0.76), coronary heart disease (OR 0.75, 95% CI 0.61 to 0.71) and peripheral vascular disease (OR 0.83, 95% CI 0.71 to 0.97).
  
  
  CONCLUSIONS
  People with schizophrenia have a wide range of comorbid and multiple physical-health conditions but are less likely than people without schizophrenia to have a primary care record of cardiovascular disease. This suggests a systematic under-recognition and undertreatment of cardiovascular disease in people with schizophrenia, which might contribute to substantial premature mortality observed within this patient group.
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Smith
authors.forename: Julie
authors.initials: J
authors.lastname: Langan
authors.forename: Gary
authors.initials: G
authors.lastname: McLean
authors.forename: Bruce
authors.initials: B
authors.lastname: Guthrie
authors.forename: Stewart W
authors.initials: SW
authors.lastname: Mercer