Chronic physical illnesses in patients with schizophrenia spectrum disorders are independently associated with higher rates of psychiatric rehospitalization; a cross-sectional study in Croatia

Filipčić, Igor; Ivezić, Ena; Matić, Katarina; Vukadinović, Nikolina Tunjić; Pisk, Sandra Vuk; Bodor, Davor; Bajić, Žarko; Jakovljević, Miro; Sartorius, Norman

doi:10.1016/j.eurpsy.2017.02.484

Cited by 24 publications

(12 citation statements)

References 44 publications

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“…Our ﬁnding was consistent with other studies that reported the association between general Physical comorbidity and increased risk of psychiatric readmission. 21 , 25 , 27 Discharged patients with severe mental illness diagnoses, a higher CCI score and medical health problems were more probable to experience a subsequent hospital admission. 24 Some previous studies’ outcomes also supported the hypothesis that patients with psychiatric disorders were at increased risk of rehospitalization if they had co-occurring somatic conditions.…”

Section: Discussionmentioning

confidence: 99%

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<p>Physical Comorbidities are Independently Associated with Higher Rates of Psychiatric Readmission in a Chinese Han Population</p>

Yang¹,

Zhong²,

Zhou³

et al. 2020

NDT

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Background In people with psychosis, physical comorbidities are highly widespread and leading contributors to the untimely death encountered. Readmission rates in psychiatric patients are very high. Somatic comorbidities could be one of the considerable risk factors for psychiatric rehospitalization. Nevertheless, much less is known about the relation between physical comorbidities and psychiatric readmission. We aimed to investigate the association between physical comorbidities and psychiatric readmission in Han Chinese patients with psychiatric disorders. Methods We used administrative data for January 1, 2009 to December 31, 2018 from the headquarters of the Affiliated Brain Hospital of Guangzhou Medical University to identify adults with schizophrenia, unipolar depression or bipolar disorder discharged from hospital. Data were extracted on sociodemographic and clinical characteristics. The Charlson comorbidity index (CCI) was used to assess the existence of significant physical comorbidity. Cox proportional hazards regression estimated rehospitalization risk after discharge. Results A total of 15,620 individuals were included in this study, with the mean age of 35.1 years (SD = 12.8), and readmission occurred for 23.6% of participants. Survival analysis showed that physical comorbidities were statistically and significantly associated with psychiatric readmission, even after the adjustment for the number of psychiatric comorbidities, other sociodemographic and clinical variables. Conclusion Our results suggest that somatic comorbidities are related with higher rates of psychiatric readmission. Hence, to treat psychosis more effectively and to reduce rehospitalization, it is crucial to treat physical comorbidities promptly and adequately. It is absolutely necessary to bring somatic comorbidities to the forefront of psychiatric treatment and research.

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Section: Discussionmentioning

confidence: 99%

“…For example, Filipcic et al found that chronic somatic comorbidities were linked with higher rates of psychiatric readmission. 25 Nevertheless, Clements et al reported that there was no association between them. 26 …”

Section: Introductionmentioning

confidence: 99%

<p>Physical Comorbidities are Independently Associated with Higher Rates of Psychiatric Readmission in a Chinese Han Population</p>

Yang¹,

Zhong²,

Zhou³

et al. 2020

NDT

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“…Poor periodontal status further deteriorates patients' quality of life. In addition, a growing body of literature indicates there are possible effects of the somatic illness on the efficacy of treatment of psychosis itself [22][23][24]. Kalakonda et al proposed the hypothetical model of bidirectional association between periodontal disease and schizophrenia in which psychosis and its treatment determines the poor oral hygiene, xerostomia and lower utilization of dental healthcare, while periodontal disease causes elevation in interleukins and in that way indirectly modulates the dopaminergic metabolism [5].…”

Section: Introductionmentioning

confidence: 99%

Untitled

2019

Arch. Psychiatry Res.

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Objectives-The aim of this prospective cohort study was to investigate whether the association of periodontal status with schizophrenia treatment outcomes differs by patient's age. Subjects and methods-The study was performed on the consecutive sample of 67 patients diagnosed with schizophrenia and discharged because achieving remission criteria. Papilla bleeding index (PBI) was measured at hospital discharge. Positive and negative syndrome scale (PANSS) total score, positive, negative and general symptoms subscales' scores were measured at hospital discharge, after three, and after six months. Results:-After the adjustment for potential confounders, baseline PBI was significantly unfavorably associated with PANSS total score, negative and general symptoms subscales scores in the patients younger than 45 three and six months after the hospital discharge, and with the positive symptoms sub-scale in patients younger than 34. At youngest 10% of patients, a unit difference in baseline PBI resulted in the 8.12 (95% CI 2.78-13.47; p=0.004) points higher total PANSS score three months later. Our study showed that the younger patients with worse periodontal status are at higher risk for poorer schizophrenia treatment outcomes and faster worsening of remission. This study demonstrates the necessity of more rigorous and more frequent control of younger schizophrenia patients with worse periodontal status after hospital discharge to achieve overall improvement of the patients' quality of life as well as the efficacy of psychiatric therapies aimed toward the primary mental disorder.

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“…[10–12] Furthermore, the CPI may affect treatment outcomes in SSD and are associated with increased costs. [13–16] It is thus essential not only to manage the symptoms of schizophrenia but also to treat comorbid physical illnesses [17] as physical healthcare needs of SSD patients are elevated. Some studies indicated that the access and utilization of different non-psychiatric health care services in this population is below the general population (GEP).…”

Section: Introductionmentioning

confidence: 99%

Utilization of somatic healthcare in Croatian patients with schizophrenia spectrum disorder, major depression, PTSD and the general population

Jeleč¹,

Bajić²,

Filipčić³

et al. 2019

BMC Psychiatry

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Background Utilization of somatic healthcare services is highly predictive of the development of chronic physical illnesses and increased mortality risks. The objective of this study was to assess the differences in healthcare utilization among patients with schizophrenia spectrum disorders (SSD), major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) and the general population in Croatia. Methods We enrolled 566 Croatian participants from the general population, 282 with SSD, 178 with MDD, and 86 with PTSD. The primary outcome was a self-reported specialist consultation for non-psychiatric (e.g., somatic) causes within the previous 12 months. Results Although SSD patients with chronic physical illnesses were significantly more often hospitalized for physical illness than the general population, the proportion of patients who had a specialist consultation were equal in SSD and the general population. MDD and PTSD patients had significantly higher adjusted odds for specialist consultation than the general population and SSD patients (MDD compared to SSD: OR = 2.14; 95% CI 1.27–3.59; PTSD compared to SSD: OR = 2.03; 95% CI 1.00–4.10). Conclusions SSD patients’ utilization of somatic healthcare is equal to the general population, despite their increased healthcare needs. However, their utilization is lower than in MDD and PTSD patients and, therefore, probably not adequate. Trial registration The study protocol was registered at ClinicalTrials.gov ( NCT02773108 ) on May 16, 2016.

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Chronic physical illnesses in patients with schizophrenia spectrum disorders are independently associated with higher rates of psychiatric rehospitalization; a cross-sectional study in Croatia

Cited by 24 publications

References 44 publications

<p>Physical Comorbidities are Independently Associated with Higher Rates of Psychiatric Readmission in a Chinese Han Population</p>

<p>Physical Comorbidities are Independently Associated with Higher Rates of Psychiatric Readmission in a Chinese Han Population</p>

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Utilization of somatic healthcare in Croatian patients with schizophrenia spectrum disorder, major depression, PTSD and the general population

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