Report reveals urgent need to improve physical health of people with Schizophrenia

Apr 27 2005

People with schizophrenia often die prematurely. However researchers from the University of Glasgow and NHS Greater Glasgow assert that much of the excess mortality of schizophrenia is preventable through lifestyle changes and the treatment of common diseases.

Schizophrenia, its treatment and the lifestyle of sufferers contribute to high rates of illness and mortality. Sufferers often have poorer diets, lower rates of physical activity and smoke more than the general population. Such lifestyle 'choices' predispose them to poor physical health and diseases.

Schizophrenia is a disabling mental illness where disordered thinking disturbs an individual's ability to function normally in society. It affects around one in 100 people across Europe. 10-13% of people with schizophrenia commit suicide but most of the excess mortality in schizophrenia is from natural causes.

Cardio-vascular risk factors in people with schizophrenia are a consequence of the illness itself, related behaviours, lifestyle and treatments. It is important that mental health and primary care services appreciate the risks they face and how the illness contributes to premature death.

Excessive body weight increases the risk of ill health, and is the biggest risk factor for type 2 diabetes caused by antipsychotics. Sufferers are also predisposed to hypertension, heart disease, stroke, osteoarthritis, respiratory problems and some cancers.

Research has shown that people with schizophrenia are more obese than the non-schizophrenic population. Weight loss interventions for people with schizophrenia should start with regular and frequent weight monitoring and address exercise, and lifestyle advice. Switching of antipsychotic medication to one with less-tendency for weight gain and the use of specific anti-obesity drugs could also help combat obesity in patients.

However, in Glasgow much work is already underway to tackle poor physical health amongst people with schizophrenia. The integrated schizophrenia care pathway provides a structured route to ensure that physical as well as mental health needs of patients are addressed; GPs and mental health staff are working together to improve physical health; and support is available from grassroots projects where people can have their mental and physical health needs assessed at local mental health resource centres across the city.

Dr Moira Connolly, report author and Consultant Psychiatrist, NHS Greater Glasgow, said: “It's important that sufferers get the right type of support from medical and social services. The potential for improving the overall health of this group of people is only starting to be addressed. However in Glasgow there is already a lot of good work underway to tackle the problems of poor physical health - such as services which give advice on healthy lifestyles as well as mental health support and treatment; and much closer working between primary care and mental health professionals to identify physical health issues.

“Improving physical health is critical to improving the quality of life for people with schizophrenia. The challenge is to ensure that the physical health of patients with schizophrenia is given the priority it deserves, helping them to face their future with the lowest possible illness and mortality odds stacked against them.”

People with schizophrenia may fail to recognise the early signs of physical ill health or choose to avoid contact with health services. The traditional routes to obtaining health care may prove too complex for someone who is chronically distressed by symptoms or lacking in the motivation required to make and attend an appointment. Guidelines for clinicians and integrated working across mental health, primary care and social care services could help improve access to health care for people with schizophrenia.

The researchers also assert that the evaluation of new therapies should include assessments of long-term risk to physical health in addition to psychiatric effects.