Harvard Mental Health Letter

In Brief: Schizophrenia and physical illness

In Brief

Schizophrenia and physical illness

Two new studies explore different aspects of medical illness in schizophrenic patients. In one study, conducted in Iowa, researchers collected medical claims from Blue Cross Blue Shield records for more than 1,000 people with schizophrenia and more than 700,000 controls over a six-year period. Adjusting for age, the schizophrenic patients (average age, 40) had a higher rate of chronic illnesses affecting almost every system in the body.

They were nearly three times as likely to be smokers (dependent on nicotine), and suffering from hypothyroidism (low thyroid function), and they had nearly eight times the rate of the infectious disease hepatitis C. They were about twice as vulnerable to such disorders as asthma, stroke, peripheral vascular disease, chronic obstructive pulmonary disease, and diabetes. Their rate of coronary artery disease and high blood pressure was only slightly higher than average, possibly because they are correctly diagnosed for these commonly symptomless disorders even less often than most people.

Physical illness becomes chronic in schizophrenic patients partly because they get insufficient treatment. They may not seek treatment themselves, and mental health professionals are not always keeping track of their physical condition. The resulting ill health raises the risk of prolonged hospitalization, suicide, accidents, and drug overdoses. Some disorders, especially hypothyroidism, can exacerbate psychiatric symptoms.

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