Psychotic symptoms alone denote medical health risk

By Eleanor McDermid, Senior medwireNews Reporter

People with symptoms of psychosis have an increased rate of medical comorbidities and unhealthy lifestyle habits even if they do not have a psychiatric diagnosis, shows a worldwide study.

They also had increased rates of healthcare indicators such as nonpsychiatric hospital stays, and prescribed medications.

Poor medical health is an established phenomenon in patients with psychotic diagnoses. However, the current findings “suggest that this relationship is not dependent on the presence of a psychotic disorder, but that the critical factor is having experienced at least one psychotic symptom,” say lead study author Carmen Moreno (Hospital General Universitario Gregorio Marañón, Madrid, Spain) and co-workers.

Their findings are based on data from 224,254 participants in the World Health Organization World Health Survey, which covers 52 countries. The survey included 27,648 people who had no psychotic diagnosis but had experienced at least one psychotic symptom during the previous 12 months. These individuals had significantly higher rates of conditions such as angina pectoris, asthma, arthritis, and tuberculosis than the 195,300 people with no symptoms of psychosis, as well as more vision, hearing, and teeth problems. They were also more likely to smoke or drink alcohol.

“Given the sample analyzed, this trend seems to hold worldwide, regardless of the socio-economic development of the country or the specific health care system,” writes the team in World Psychiatry.

Most healthcare indicators, such as overnight hospital stays and use of nonpsychiatric medicines, were significantly increased in patients with psychotic symptoms but no diagnosis relative to those without symptoms, and their self-rated health was poorer.

Indeed, these patients had increased rates of all the same comorbidities and healthcare indicators as did the 1306 patients who had a psychotic diagnosis plus recent symptoms, although the size of the effect was not as large.

“Patients with psychotic disorders and even with psychotic symptoms not fulfilling diagnostic criteria for a psychotic disorder should be screened for additional medical problems,” say Moreno et al.

They add that “general practitioners should be trained in the identification of patients with these problems, in order to optimize the functioning of health systems and avoid the problems and additional costs associated with comorbid conditions.”

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