Medical Comorbidity and Receipt of Medical Care by Older Homeless People With Schizophrenia or Depression

Folsom, David P.; McCahill, Margaret E.; Bartels, Stephen J.; Lindamer, Laurie A.; Ganiats, Théodore G.; Jeste, Dilip V.

doi:10.1176/appi.ps.53.11.1456

Cited by 101 publications

(73 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For example, a recent population wide study in Australia showed that although people with schizophrenia suffer more frequently from cardiovascular problems than the general population, they are prescribed a heart catheterization much less frequently than the general population (9). People with mental disorders were also reported to be less likely to be placed on HbA1c and cholesterol monitoring (10), to have a retinal examination if they have diabetes (11), to be treated for osteoporosis (12); to receive medical visits (13,14); and they are treated for a physical disease only if it is life-threatening (15). Physical comorbidities are an issue which is emerging as a priority in the mental health field.…”

Section: Introductionmentioning

confidence: 99%

Physical illness and schizophrenia: a review of the literature

Leucht

Burkard

Henderson³

et al. 2007

Acta Psychiatr Scand

564

358

View full text Add to dashboard Cite

Sartorius N. Physical illness and schizophrenia: a review of the literature.Objective: The lifespan of people with schizophrenia is shortened compared to the general population. We reviewed the literature on comorbid physical diseases in schizophrenia to provide a basis for initiatives to fight this unacceptable situation. Method: We searched MEDLINE (1966( -May 2006 combining the MeSH term of schizophrenia with the 23 MeSH terms of general physical disease categories to identify relevant epidemiological studies. Results: A total of 44 202 abstracts were screened. People with schizophrenia have higher prevalences of HIV infection and hepatitis, osteoporosis, altered pain sensitivity, sexual dysfunction, obstetric complications, cardiovascular diseases, overweight, diabetes, dental problems, and polydipsia than the general population. Rheumatoid arthritis and cancer may occur less frequently than in the general population. Eighty-six per cent of the studies came from industrialized countries limiting the generalizability of the findings. Conclusion: The increased frequency of physical diseases in schizophrenia might be on account of factors related to schizophrenia and its treatment, but undoubtedly also results from the unsatisfactory organization of health services, from the attitudes of medical doctors, and the social stigma ascribed to the schizophrenic patients. Summations• According to this review it has been known for decades that incidences physical diseases are frequent in schizophrenia. Nevertheless, some areas such as infectious diseases have not been sufficiently studied.• Psychiatrists are often not trained well enough in the detection and treatment of physical diseases.They must be aware of the frequent medical comorbidities and should play a more active role in their diagnosis, prevention, and treatment.• Other necessary strategies include the education of patients, general practitioners and of doctors working in other medical specialities. The access to medical care of the mentally ill also needs to be improved, among others, by reducing the stigma associated with mental disorders. Considerations• The review covered a broad area of research accordingly, focusing attention to details has not been possible.• Despite the broad search strategy, studies not covered by MEDLINE or not indexed by the MeSH term of schizophrenia could have been missed. • Due to considerable differences in the design and quality of the studies in assorted and diverse areas, quantitative approaches using meta-analysis were not possible, but should be the target of future reviews focusing.

show abstract

Section: Introductionmentioning

confidence: 99%

Physical illness and schizophrenia: a review of the literature

Leucht

Burkard

Henderson³

et al. 2007

Acta Psychiatr Scand

564

358

View full text Add to dashboard Cite

show abstract

“…7 Several studies have addressed the association of chronic mental illnesses, such as depression, with use of general medical care. [8][9][10][11][12] These studies indicate poor adherence to medical treatment and follow-up as well as worse outcome in the population with psychiatric illness or substance use disorder or dual diagnoses. Few of these studies looked specifically at preventive care and cancer screening among patients with chronic mental illnesses.…”

Section: Introductionmentioning

confidence: 99%

Are Depressive Symptoms Associated with Cancer Screening and Cancer Stage at Diagnosis among Postmenopausal Women? The Women's Health Initiative Observational Cohort

Aggarwal

Freund

Sato

et al. 2008

Journal of Women's Health

View full text Add to dashboard Cite

Background: Women with depressive symptoms may use preventive services less frequently and experience poorer health outcomes. We investigated the association of depressive symptoms with breast and colorectal cancer screening rates and stage of cancer among a cohort of postmenopausal women. Methods: In The Women's Health Initiative Observational Study, 93,676 women were followed on average for 7.6 years. Depressive symptoms were measured at baseline and at 3 years using the 6-item scale from the Center for Epidemiological Studies Depression scale (CES-D). We calculated a cancer screening rate expressed as a proportion of the years that women were current with recommended cancer screening over the number of follow-up visits in the study. Breast and colorectal cancers were staged based on Surveillance, Epidemiology and End Results (SEER) classification. Results: At baseline, 15.8% (12,621) women were positive for depressive symptoms, and 6.9% (4,777) were positive at both baseline screening and at 3 years. The overall average screening rate was 71% for breast cancer and 53% for colorectal cancer. The breast cancer screening rate was 1.5% (CI 0.9%-2.0%) lower among women who reported depressive symptoms at baseline than among those who did not. Depressive symptoms were not a predictor for colorectal cancer screening. Stage of breast and colorectal cancer was not found to be associated with depressive symptoms after adjusting for covariates. Conclusions: Among a healthy and self-motivated cohort of women, self-reported depressive symptoms were associated with lower rates of screening mammography but not with colorectal cancer screening.

show abstract

“…Higher prevalence of hypertension and higher average blood pressure values observed in the general population are essentially due to the high proportion of overweight and obese individuals 57 . Previous studies conducted among the homeless yielded prevalence of hypertension ranging between the 14% and 51% 14,15,17,18,19,20,21 .…”

Section: Discussionmentioning

confidence: 99%

“…In addition to a high prevalence of diabetes and hypercholesterolemia, the increased risk of cardiovascular disease has been attributed essentially to a high prevalence of hypertension and substance abuse 12,13,14,15,16 . Several studies reported prevalence of hypertension among the homeless ranging from 14% to 51% 14,15,17,18,19,20,21 , and prevalence of tobacco and alcohol consumption of almost 80% and 30% respectively 12,14,22 . Furthermore, the fact that the homeless population experiences difficulties in obtaining and maintaining stable sources of medical care has also been described as a barrier to appropri-ARTIGO ARTICLE ate healthcare 23,24,25 that contributes to a lack of awareness of these health problems and difficulties in adhering to treatment regimens 26 .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for cardiovascular disease among the homeless and in the general population of the city of Porto, Portugal

et al. 2012

View full text Add to dashboard Cite

We described the distribution of risk factors for cardiovascular disease among homeless people living in the city of Porto, Portugal. Comparisons were made between subsamples of homeless people recruited in different settings and between the overall homeless sample group and a sample of the general population. All "houseless" individuals attending one of two homeless hostels or two institutions providing meal programs on specific days were invited to participate and were matched with subjects from the general population. We estimated sex, age and education-adjusted prevalence ratios or mean differences. The prevalence of previous illicit drug consumption and imprisonment was almost twice as high among the homeless from institutions providing meal programs. This group also showed lower mean systolic and diastolic blood pressure. Prevalence of smoking was almost 50% higher in the overall homeless group. Mean body mass index and waist circumference were also lower in the homeless group and its members were almost five times less likely to report dyslipidemia. Our findings contribute to defining priorities for interventions directed at this segment of society and to reducing inequalities in this extremely underprivileged population.

show abstract

Medical Comorbidity and Receipt of Medical Care by Older Homeless People With Schizophrenia or Depression

Abstract: Middle-aged and older homeless people with schizophrenia received less primary and preventive health care and were treated for fewer chronic medical problems than a comparison group with depression.

Cited by 101 publications

References 27 publications

Physical illness and schizophrenia: a review of the literature

Physical illness and schizophrenia: a review of the literature

Are Depressive Symptoms Associated with Cancer Screening and Cancer Stage at Diagnosis among Postmenopausal Women? The Women's Health Initiative Observational Cohort

Risk factors for cardiovascular disease among the homeless and in the general population of the city of Porto, Portugal

Contact Info

Product

Resources

About