Community Mental Health Journal

, Volume 41, Issue 2, pp 169–184

The Poor General Health of the Severely Mentally Ill: Impact of Schizophrenic Diagnosis

  • R. N. Linda Chafetz
  • R. N. Mary C. White
  • R. N. Gerri Collins-Bride
  • John Nickens
Article

Abstract

This study focused on poor health among the severely mentally ill and additional risks associated with schizophrenia. Records of 781 clients in short-term residential treatment programs provided data. The schizophrenic subgroup was compared to others in bivariate analyses, with significant findings included in logistic regression. Those with schizophrenia were more likely to be male, unemployed, and insured by MediCal/Medicare. Most health problems occurred at similar rates across diagnoses, reflecting common environmental risk factors. Those with schizophrenia had less substance abuse and fewer liver conditions, but more diabetes and chronic respiratory problems. Implications for providers and for research are discussed.

Keywords

schizophrenia severe mental illness medical co-morbidity diabetes respiratory risk factors 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Blank, M. B., Mandell, D. S., Aiken, L., Hadley, T. R. 2002Co-occurrence of HIV and serious mental illness among Medicaid recipientsPsychiatric Services53868873CrossRefPubMedGoogle Scholar
  2. Brown, S., Inskip, H., Barraclough, B. 2000Causes of the excess mortality of schizophreniaBritish Journal of Psychiatry177212217CrossRefPubMedGoogle Scholar
  3. Cradock-O’Leary, J., Young, A. S., Yano, E. M., Wang, M., Lee, M. L. 2002Use of general medical services by VA patients with psychiatric disordersPsychiatric Services53874878CrossRefPubMedGoogle Scholar
  4. Dickerson, F. B., Ringel, N., Parente, F. 1999Predictors of residential independence among outpatients with schizophreniaPsychiatric Services50515519PubMedGoogle Scholar
  5. Dickey, B., Normand, S. L., Weiss, R. D., Drake, R. E., Azeni, H. 2002Medical morbidity, mental illness, and substance use disordersPsychiatric Services53861867CrossRefPubMedGoogle Scholar
  6. Dixon, L., Postrado, L., Delahanty, J., Fischer, P. J., Lehman, A. 1999The association of medical co-morbidity in schizophrenia with poor physical and mental healthJournal of Nervous and Mental Disease187496502CrossRefPubMedGoogle Scholar
  7. Dixon, L., Weiden, P., Delahanty, J., Goldberg, R., Postrado, L., Lucksted, A., Lehman, A. 2000Prevalence and correlates of diabetes in national schizophrenia samplesSchizophrenia Bulletin26903912PubMedGoogle Scholar
  8. Druss, B. G., Bradford, W. D., Rosenheck, R. A., Radford, M. J., Krumholz, H. M. 2000Mental disorders and use of cardiovascular procedures after myocardial infarctionThe Journal of the American Medical Association283506511CrossRefGoogle Scholar
  9. Druss, B. G., Bradford, W. D., Rosenheck, R. A., Radford, M. J., Krumholz, H. M. 2001Quality of medical care and excess mortality in older patients with mental disordersArchives of General Psychiatry58565572CrossRefPubMedGoogle Scholar
  10. Fields, S. L.,  et al. 1995

    Progress Foundation, San Francisco

    Warner, R. eds. Alternatives to the hospital for acute psychiatric treatment.American Psychiatric PressWashington DC5773
    Google Scholar
  11. Folsom, D. P., McCahill, M., Bartels, S. J., Lindamer, L. A., Ganiats, T. G., Jeste, D. V. 2002Medical comorbidity and receipt of medical care by older homeless people with schizophrenia or depressionPsychiatric Services5314561460CrossRefPubMedGoogle Scholar
  12. Gelberg, L., Doblin, B. H., Leake, B. D. 1996Ambulatory health services provided to low-income and homeless adult patients in a major community health centerJournal of General Internal Medicine11156162PubMedGoogle Scholar
  13. Hampton, M. D., Chafetz, L. 2002Factors associated with residential placement in an assertive community treatment programIssues in Mental Health Nursing23677689CrossRefPubMedGoogle Scholar
  14. Hannerz, H., Borga, P. 2000Mortality among persons with a history as psychiatric inpatients with functional psychosisSocial Psychiatry and Psychiatric Epidemiology35380387CrossRefPubMedGoogle Scholar
  15. Hansen, V., Jacobsen, B. K., Arnesen, E. 2001Cause-specific mortality in psychiatric patients after deinstitutionalisationBritish Journal of Psychiatry199438443CrossRefGoogle Scholar
  16. Harris, E. C., Barraclough, B. 1998Excess mortality of mental disorderBritish Journal of Psychiatry171153CrossRefGoogle Scholar
  17. Havassy, B. E., Arns, P. G. 1998Relationship of cocaine and other substance dependence to well-being of high-risk psychiatric patientsPsychiatric Services49935940PubMedGoogle Scholar
  18. Hoyer, E. H., Mortensen, P. B., Olesen, A. V. 2000Mortality and causes of death in a total national sample of patients with affective disorders admitted for the first time between 1973 and 1993British Journal of Psychiatry1767682CrossRefPubMedGoogle Scholar
  19. Joukamaa, M., Heliovaara, M., Knekt, P., Aromaa, A., Raitasalo, R., Lehtinen, V. 2001Mental disorders and cause-specific mortalityBritish Journal of Psychiatry179498502CrossRefPubMedGoogle Scholar
  20. Kane, J. M. 2003Oral ziprasidone in the treatment of schizophrenia: a review of short-term trialsJournal of Clinical Psychiatry641925PubMedGoogle Scholar
  21. Kessler, R. C., Crum, R. M., Warner, L. A., Nelson, C. B., Schulenberg, J., Anthony, J. C. 1997Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity SurveyArchives of General Psychiatry54313321PubMedGoogle Scholar
  22. Lawrence, D. M., Holman, C. D., Jablensky, A. V., Hobbs, M. S. 2003Death rate from ischaemic heart disease in Western Australian psychiatric patients 1980–1998British Journal of Psychiatry1823136CrossRefPubMedGoogle Scholar
  23. Lawrence, D., Jablensky, A. V., Holman, C. D. J., Pinder, T. J. 2000Mortality in Western Australian psychiatric patientsSocial Psychiatry Psychiatric Epidemiology35341347CrossRefGoogle Scholar
  24. Lyon, E. 1999A review of the effects of nicotine on schizophrenia and anti-psychotic medicationsPsychiatric Services5013461350PubMedGoogle Scholar
  25. Melkersson, K., Dahl, M. L. 2004Adverse metabolic effects associated with atypical antipsychotics: literature review and clinical implicationsDrugs64701723PubMedGoogle Scholar
  26. Osby, U., Brandt, L., Correia, N., Ekbom, A., Sparen, P. 2001Excess mortality in bipolar and unipolar disorder in SwedenArchives of General Psychiatry58844850CrossRefPubMedGoogle Scholar
  27. Osby, U., Correia, N., Brandt, L., Ekbom, A., Sparen, P. 2000Mortality and causes of death in schizophrenia in Stockholm county, SwedenSchizophrenia Research452128CrossRefPubMedGoogle Scholar
  28. Osher, F. C., Goldberg, R. W., McNary, S. W., Swartz, M. S., Essock, S. M., Butterfield, M. I.,  et al. 2003Five-Site Health and Risk Study Research Committee. Substance abuse and the transmission of hepatitis C among persons with severe mental illnessPsychiatric Services54842847CrossRefPubMedGoogle Scholar
  29. Pandiani, J. A., Banks, S. M., Bramley, J., Moore, R. 2002Mortality of mental health service recipients in Vermont and OklahomaPsychiatric Services5310251027CrossRefPubMedGoogle Scholar
  30. Potkin, S. G., Saha, A. R., Kujawa, M. J., Carson, W. H., Ali, M., Stock, E., Stringfellow, J., Ingenito, G., Marder, S. R. 2003Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs. placebo in patients with schizophrenia and schizoaffective disorderArchives of General Pshychiatry60681690CrossRefGoogle Scholar
  31. Progress Foundation (1997–1998). Unpublished data. San Francisco, California.Google Scholar
  32. Ryan, M. C., Collins, P., Thakore, J. H. 2003Impaired fasting glucose tolerance in first-episode, drug-naive patients with schizophreniaThe American Journal of Psychiatry160284289CrossRefPubMedGoogle Scholar
  33. Ryan, M. C., Thakore, J. H. 2002Physical consequences of schizophrenia and its treatment: the metabolic syndromeLife Sciences71239257CrossRefPubMedGoogle Scholar
  34. Segal, S. P., Vandervoort, D. J., Liese, L. H. 1993Residential status and the physical health of a mentally ill populationHealth Social Work18208214PubMedGoogle Scholar
  35. Sernyak, M. J., Leslie, D. L., Alarcon, R. D., Losonczy, M. F., Rosenheck, R. 2002Association of diabetes mellitus with use of atypical neuroleptics in the treatment of schizophreniaAmerican Journal of Psychiatry159561566CrossRefPubMedGoogle Scholar
  36. White, M. C., Tulsky, J. P., Dawson, C., Zolopa, A. R., Moss, A. R. 1997Association between time homeless and perceived health status among the homeless in San FranciscoJournal of Community Health22271282CrossRefPubMedGoogle Scholar
  37. Wirshing, D. A., Pierre, J. M., Erhart, S. M., Boyd, J. A. 2003Understanding the new and evolving profile of adverse drug effects in schizophreniaThe Psychiatric Clinics of North America26165190CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • R. N. Linda Chafetz
    • 1
  • R. N. Mary C. White
    • 1
  • R. N. Gerri Collins-Bride
    • 1
  • John Nickens
    • 2
  1. 1.San Francisco Community Health Systems, School of NursingUniversity of CaliforniaUSA
  2. 2.San Francisco Progress FoundationUSA

Personalised recommendations