BMJ Open：精神分裂症与躯体疾病共病相关

　　一项来自英国的横向研究发现，精神分裂症患者具有各种各样的共病和多重躯体疾病共病，但与非精神分裂症患者相比，精神分裂症患者在初级保健记录中有心血管疾病的几率更低。这表明医生对于精神分裂症患者中心血管疾病的识别和治疗可能不足，这可能导致大家在这个患者群中所观察到的过早死亡。相关论文于2013年4月17日发表于BMJ Open杂志上。

　　该研究旨在评估与对照组相比，精神分裂症和相关重性精神病患者中躯体疾病共病的性质和程度。

　　研究纳入了来自苏格兰的314家初级保健诊所的初级保健记录中患有精神分裂症或相关重性精神病的患者9677名，对照者1414701名。主要转归指标为校正了年龄、性别和剥夺状态后，32个常见的慢性躯体疾病状况和合并一个、两个、三个或多个躯体疾病共病的初级保健记录。

　　结果显示，与对照组相比，精神分裂症患者明显更可能存在一种躯体疾病共病（OR 1.21），两种躯体疾病共病（OR 1.37）和三种或更多躯体疾病共病（OR 1.19）。病毒性肝炎（OR 3.98）、便秘（OR 3.24）和帕金森病（OR 3.07）的共病率最高，但精神分裂症患者所记录到的心血管疾病〔包括房颤（OR 0.62）、高血压（OR 0.71）、冠心病（OR 0.75）和周围血管疾病（OR 0.83）〕的共病率较低。

与精神分裂相关的拓展阅读：

• EPA 2013：吸食大麻与精神分裂症较严重相关
• Biol Psychiatry：TMS可改善精神分裂症患者的记忆
• Am J Psychiatry：围产期补充胆碱或减少孩子患精神分裂症风险
• Psychiatry Res：SOD等或预测精神分裂症急性期严重程度
• JAMA Psychiatry：饮食补充剂或可改善精神分裂症症状 更多信息请点击：有关精神分裂更多资讯

Schizophrenia is associated with excess multiple physical-health comorbidities but low levels of recorded cardiovascular disease in primary care: cross-sectional study.
OBJECTIVE
To assess the nature and extent of physical-health comorbidities in people with schizophrenia and related psychoses compared with controls.
DESIGN: Cross-sectional study.
SETTING
314 primary care practices in Scotland.
PARTICIPANTS
9677 people with a primary care record of schizophrenia or a related psychosis and 1 414 701 controls. Main outcome measures Primary care records of 32 common chronic physical-health conditions and combinations of one, two and three or more physical-health comorbidities adjusted for age, gender and deprivation status.
RESULTS
Compared with controls, people with schizophrenia were significantly more likely to have one physical-health comorbidity (OR 1.21, 95% CI 1.16 to 1.27), two physical-health comorbidities (OR 1.37, 95% CI 1.29 to 1.44) and three or more physical-health comorbidities (OR 1.19, 95% CI 1.12 to 1.27). Rates were highest for viral hepatitis (OR 3.98, 95% CI 2.81 to 5.64), constipation (OR 3.24, 95% CI 3.00 to 4.49) and Parkinson's disease (OR 3.07, 95% CI 2.42 to 3.88) but people with schizophrenia had lower recorded rates of cardiovascular disease, including atrial fibrillation (OR 0.62, 95% CI 0.51 to 0.73), hypertension (OR 0.71, 95% CI 0.67 to 0.76), coronary heart disease (OR 0.75, 95% CI 0.61 to 0.71) and peripheral vascular disease (OR 0.83, 95% CI 0.71 to 0.97).
CONCLUSIONS
People with schizophrenia have a wide range of comorbid and multiple physical-health conditions but are less likely than people without schizophrenia to have a primary care record of cardiovascular disease. This suggests a systematic under-recognition and undertreatment of cardiovascular disease in people with schizophrenia, which might contribute to substantial premature mortality observed within this patient group.