Mortality, morbidity and medical resources utilization of patients with schizophrenia: A case-control community-based study

Gur, Shay; Weizman, Shira; Stubbs, Brendon; Matalon, André; Meyerovitch, Joseph; Hermesh, Haggai; Krivoy, Amir

doi:10.1016/j.psychres.2017.11.042

Cited by 37 publications

(21 citation statements)

References 36 publications

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“…The consequences of concurrent general medical and psychiatric illnesses include an increase in morbidity, mortality, healthcare utilization and costs [ 3 ]. All psychiatric disorders are associated with increased morbidity, and mortality and patients who suffer from eating disorders and substance dependence have the highest risk[ 4 – 7 ]. Numerous studies examined the relationship between medical-psychiatric comorbidities and health-economic outcomes.…”

Section: Introductionmentioning

confidence: 99%

Health-economic outcomes in hospital patients with medical-psychiatric comorbidity: A systematic review and meta-analysis

et al. 2018

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BackgroundHospital inpatients often experience medical and psychiatric problems simultaneously. Although this implies a certain relationship between healthcare utilization and costs, this relationship has never been systematically reviewed.ObjectiveThe objective is to examine the extent to which medical-psychiatric comorbidities relate to health-economic outcomes in general and in different subgroups. If the relationship is significant, this would give additional reasons to facilitate the search for targeted and effective treatments for this complex population.MethodA systematic review in Embase, Medline, Psycinfo, Cochrane, Web of Science and Google Scholar was performed up to August 2016 and included cross-references from included studies. Only peer-reviewed empirical studies examining the impact of inpatient medical-psychiatric comorbidities on three health-economic outcomes (length of stay (LOS), medical costs and rehospitalizations) were included. Study design was not an exclusion criterion, there were no restrictions on publication dates and patients included had to be over 18 years. The examined populations consisted of inpatients with medical-psychiatric comorbidities and controls. The controls were inpatients without a comorbid medical or psychiatric disorder. Non-English studies were excluded.ResultsFrom electronic literature databases, 3165 extracted articles were scrutinized on the basis of title and abstract. This resulted in a full-text review of 86 articles: 52 unique studies were included. The review showed that the presence of medical-psychiatric comorbidity was related to increased LOS, higher medical costs and more rehospitalizations. The meta-analysis revealed that patients with comorbid depression had an increased mean LOS of 4.38 days compared to patients without comorbidity (95% CI: 3.07 to 5.68, I2 = 31%).ConclusionsMedical-psychiatric comorbidity is related to increased LOS, medical costs and rehospitalization; this is also shown for specific subgroups. This study had some limitations; namely, that the studies were very heterogenetic and, in some cases, of poor quality in terms of risk of bias. Nevertheless, the findings remain valid and justify the search for targeted and effective interventions for this complex population.

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Section: Introductionmentioning

confidence: 99%

Health-economic outcomes in hospital patients with medical-psychiatric comorbidity: A systematic review and meta-analysis

et al. 2018

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“…Despite reductions in mortality in the general population over the last 30 years (both all-cause and cardiovascular) (4), the mortality gap between patients with schizophrenia and the healthy population is not reducing (5), and may even be increasing (6). Cardiovascular disease (CVD) accounts for a large part of the loss of life in schizophrenia(7) (14.3 life-years lost (8), or 60% of deaths(9), on average) despite being underdiagnosed (10), and its importance has been increasing both in US-based (9) and north-European (4) population samples.…”

Section: Introductionmentioning

confidence: 99%

Cardiac structure and function in schizophrenia: a cardiac MR imaging study

Osimo

Brugger

Marvao

et al. 2019

Preprint

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Background: Heart disease is the leading cause of death in schizophrenia. Aims: We investigated cardiac structure and function in patients with schizophrenia using cardiac magnetic resonance imaging (CMR) after excluding medical and metabolic comorbidity. Methods: 80 participants underwent CMR to determine biventricular volumes and function and measures of blood pressure, physical activity, and glycated haemoglobin levels. Patients and controls were matched for age, sex, ethnicity, and body surface area. Results: Patients with schizophrenia had significantly smaller indexed left ventricular (LV) end-diastolic volume, end-systolic volume, stroke volume, right ventricular (RV) end-diastolic volume, end-systolic volume, and stroke volume but unaltered ejection fractions relative to controls. LV concentricity and septal thickness were significantly larger in schizophrenia. The findings were largely unchanged after adjusting for smoking or exercise levels and were independent of medication dose and duration. Conclusions: Patients with schizophrenia show evidence of prognostically-adverse cardiac remodelling compared to matched controls, independent of conventional risk factors.

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“…Patients with SRD have a life expectancy 13–30 years shorter than the general population [ 3 ]. SRD have been associated with an increase in morbidity and mortality [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with visits to general practitioners in patients with schizophrenia in Malaga

et al. 2018

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BackgroundPatients with psychiatric disorders have more physical problems than other patients, so their follow-up by the general practitioner is particularly important for them.MethodsWe aimed to elaborate a multilevel explanatory model of general practitioner (GP) visits made by patients with schizophrenia and related disorders (SRD). An observational, cross-sectional study was conducted from January 1, 2008 to July 1, 2011, in the area of the Clinical Management Unit of Mental Health (CMU-MH) of the Regional Hospital of Malaga (Spain). The eligible population consisted of all patients with SRD in contact with a GP residing in the study area. Our dependent variable was total number GP visits. The independent variables were: 1) patient variables (sociodemographic and clinical variables); 2) primary care centre (PCC) variables. We performed descriptive analysis, bivariate analysis and multilevel regression.ResultsFour hundred ninety four patients were included. Mean annual number of GP visits was 4.1. Female sex, living in a socioeconomically deprived area, a diagnosis of schizoaffective disorder and contact with a GP who had a more active approach to mental health issues were associated with a higher number of visits whilst being single and good communication between the PCC and mental health teams were associated with a lower number of GP visits.ConclusionsNumber of GP visits was not just associated with patient factors, but also with organisational and the involvement of health professionals, for example GPs with an active approach to mental health issues.Electronic supplementary materialThe online version of this article (10.1186/s12875-018-0866-7) contains supplementary material, which is available to authorized users.

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Mortality, morbidity and medical resources utilization of patients with schizophrenia: A case-control community-based study

Cited by 37 publications

References 36 publications

Health-economic outcomes in hospital patients with medical-psychiatric comorbidity: A systematic review and meta-analysis

Health-economic outcomes in hospital patients with medical-psychiatric comorbidity: A systematic review and meta-analysis

Cardiac structure and function in schizophrenia: a cardiac MR imaging study

Factors associated with visits to general practitioners in patients with schizophrenia in Malaga

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