Multiple physical healthcare needs among outpatients with schizophrenia: findings from a health examination study

Abstract

Background: Despite the abundant literature on physical comorbidity, the full range of the concurrent somatic healthcare needs among individuals with schizophrenia has rarely been studied.

Aims: This observational study aimed to assess the distressing somatic symptoms and needs for physical health interventions in outpatients with schizophrenia, and factors predicting those needs.

Methods: A structured, comprehensive health examination was carried out, including a visit to a nurse and a general practitioner on 275 outpatients with schizophrenia. The required interventions were classified by type of disease. Logistic regression was used to assess the influence of sociodemographic factors, lifestyle, functional limitations, factors related to psychiatric disorder, and healthcare use on the need for interventions.

Results: In total, 44.9% of the patients (mean age 44.9 years) reported somatic symptoms affecting daily life; 87.6% needed specific interventions for a disease or condition, most commonly for cardiovascular, dermatological, dental, ophthalmological, and gastrointestinal conditions, and for altered glucose homeostasis. Smoking and obesity predicted significantly a need of any intervention, but the predictors varied in each disease category. Strikingly, use of general practitioner services during the previous year did not reduce the need for interventions.

Conclusions: Health examinations for outpatients with schizophrenia revealed numerous physical healthcare needs. The health examinations for patients with schizophrenia should contain a medical history taking and a physical examination, in addition to basic measurements and laboratory tests. Prevention and treatment of obesity and smoking should be given priority in order to diminish somatic comorbidities in schizophrenia.

Keywords:

• Schizophrenia
• comorbidity
• medical history taking
• physical examination

Acknowledgements

We thank the participants and personnel at the outpatient clinics, and Marjut Grainger at the Finnish Institute for Health and Welfare for the management of the data. In addition, we thank Hyvinkää Hospital Area, Lundbeck Inc., Finnish Foundation for Psychiatric Research, Finnish Medical Foundation, Jalmari and Rauha Ahokas’s Foundation and Emil Aaltonen’s Foundation for funding of the study.

Disclosure statement

S.E. has received Speaker Honoraria from Lundbeck, Otsuka, and Janssen-Cilag, and has been a consultant for Janssen-Cilag. K.J. has received Speaker Honoraria from GSK and Janssen-Cilag. K.J. was an employee at GSK vaccines in 2013. E.S. has received Speaker Honoraria from Lundbeck, Otsuka, Janssen-Cilag, and Trafi. M.H., T.K., and J.S. report no conflicts of interest.

Additional information

Funding

This work was supported by Finnish Foundation for Psychiatric Research, Hyvinkää Hospital Area, Lundbeck Inc. [10.13039/501100003554], The Finnish Medical Foundation [10.13039/100008723], Jalmari and Rauha Ahokas Foundation [10.13039/100010125] and Emil Aaltonen Foundation [10.13039/501100004756].Funding sources played no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.