Skip to main content

Advertisement

SpringerLink
Log in

Physical illness and lifestyle risk factors in people with their first presentation of psychosis

  • ORIGINAL PAPER
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

There is an increased prevalence of physical illness and poor lifestyle in patients with chronic schizophrenia. It is unclear whether these are present at the onset of psychosis or develop over the course of illness. We aimed to establish whether patients experiencing their first episode of psychosis have worse physical health and lifestyle than community controls without psychosis.

Method

Eighty-nine patients with new onset illness were compared to age and sex matched controls for self-reported physical illness and cardiovascular and respiratory risk factors.

Results

Patients reported more physical health complaints, mainly respiratory, compared with age and gender matched controls (odds ratio 2.85, 95% confidence interval 1.2–6.7). Patients were more likely to be cigarette smokers (1.82, 95% CI 1.0–3.3) and eat a fast food diet (1.04, 95% CI 1.0–1.1), but these differences were accounted for by patients’ unemployment status.

Conclusions

Some risk factors for physical health problems are present at the onset of psychosis, but these may be explained by unemployment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Abergo E, Byrne M, Eaton WW, Mortensen PB (2004) Marital and labor market status in the long run in schizophrenia. Arch Gen Psychiatry 61:28–33

    Article  Google Scholar 

  2. Addington J, el-Guebaly N, Addington D, Hodgins D (1997) Readiness to stop smoking in schizophrenia. Can J Psychiatry 42:49–52

    PubMed  CAS  Google Scholar 

  3. Beecroft N, Becker T, Griffiths G, Leese M, Slade M, Thornicroft G (2001) Physical health care for people with severe mental illness: the role of the general practitioner (GP). J Mental Health 10:53–61

    Article  Google Scholar 

  4. Bernadt MW, Murray RM (1986) Psychiatric disorder, drinking and alcoholism: What are the links? Br J Psychiatry 148:393–400

    Article  PubMed  CAS  Google Scholar 

  5. Brown S (1997) Excess mortality of schizophrenia. A meta-analysis. Br J Psychiatry 171:502–508

    Article  PubMed  CAS  Google Scholar 

  6. Brown S, Barraclough B, Inskip H (2000) Causes of the excess mortality of schizophrenia. Br J Psychiatry 177:212–217

    Article  PubMed  CAS  Google Scholar 

  7. Brown S, Birtwhistle J, Roe L (1999) The unhealthy lifestyle of people with schizophrenia. Psychol Med 29:697–701

    Article  PubMed  CAS  Google Scholar 

  8. Connolly M, Kelly C (2005) Lifestyle and physical health in schizophrenia. Advances Psychiatric Treatment 11:125–132

    Article  Google Scholar 

  9. Cox BD, Hupport FA, Whichelow MJ, (Eds.) (1993) The health and lifestyle survey: seven years on. Darthmouth Publishing, Aldershot

    Google Scholar 

  10. de Leon J (1996) Smoking and vulnerability for schizophrenia. Schizophr Bull 22:405–409

    PubMed  Google Scholar 

  11. Dickey B, Normand SLT, Weiss RD, Drake R, Azeni H (2002) Medical morbidity, mental illness and substance use disorders. Psychiatr Serv 53:861–867

    Article  PubMed  Google Scholar 

  12. el-Guebaly N, Cathcart J, Currie S, Brown D, Gloster S (2002) Smoking cessation approaches for persons with mental illness or addictive disorders. Psychiatr Serv 53:1166–1170

    Article  PubMed  Google Scholar 

  13. Felker B, Yazel JJ, Short D (1996) Mortality and medical comorbidity among psychiatric patients: a review. Psychiatr Serv 47:1356–1363

    PubMed  CAS  Google Scholar 

  14. Fontaine KR, Mooseong H, Harrigan EP Shear CL, Lakshminarayanan M, Casey DE, Allison B (2001) Estimating the consequences of antipsychotic induced weight gain on health and mortality rate. Psychiatr Res 101:277–288

    Article  CAS  Google Scholar 

  15. Green AI, Canuso CM, Brenner MJ, Wojcik JD (2003) Detection and management of comorbidity in patients with schizophrenia. Psychiatr Clin North Am 26:115–139

    Article  PubMed  Google Scholar 

  16. Harris EC, Barraclough B (1998) Excess mortality of mental disorder. Br J Psychiatry 173:11–53

    Article  PubMed  CAS  Google Scholar 

  17. Honig A, Pop P, de Kemp E, Philipsen H, Romme M (1992) Physical illness in chronic psychiatric patients from a community psychiatric unit revisited. A three-year follow-up study. Br J Psychiatry 161:80–83

    Article  PubMed  CAS  Google Scholar 

  18. Honig A, Pop P, Tan E, Philipsen H, Romme M (1989) Physical illness in chronic psychiatric patients from a community psychiatric unit. The implications for daily practice. Br J Psychiatry 155:58–64

    Article  PubMed  CAS  Google Scholar 

  19. Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A (1992) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organisation ten-country study. Psychol Med Monogr Suppl 20:1–97

    Article  PubMed  CAS  Google Scholar 

  20. Jacobson HN, Stanton JL (1986) Pattern analysis in nutrition. Clin Nutrition 5:249–253

    Google Scholar 

  21. Jeste D, Gladsjo J, Lindamer L, Lacro J (1996) Medical comorbidity in schizophrenia. Schizophr Bull 22:413–427

    PubMed  CAS  Google Scholar 

  22. Kelly C, McCreadie R (2000) Cigarette smoking and schizophrenia. Adv Psychiatr Treatment 6:327–331

    Article  Google Scholar 

  23. Kelly C, McCreadie RG (1999) Smoking habits, current symptoms, and premorbid characteristics of schizophrenic patients in Nithsdale, Scotland. Am J Psychiatry 156:1751–1757

    PubMed  CAS  Google Scholar 

  24. Lambert TJR, Velakoulis D, Pantelis C (2003) Medical comorbidity in schizophrenia. Med J Aust 178(Suppl. 5):567–570

    Google Scholar 

  25. Lawrence DM, Holman CDJ (2003) Death rate from ischaemic heart disease in Western Australian psychiatric patients 1980–1998. Br J Psychiatry 182:31–36

    Article  PubMed  Google Scholar 

  26. Lichtermann D, Ekelund J, Pukkala E, Tanskanen A, Lonnqvist J (2001) Incidence of cancer among persons with schizophrenia and their relatives. Arch Gen Psychiatry 58:573–578

    Article  PubMed  CAS  Google Scholar 

  27. Lyketsos C, Dunn G, Kaminsky M, Breakey W (2002) Medical comorbidity in psychiatric inpatients. Relation to clinical outcomes and hospital length of stay. Psychosomatics 43:24–30

    Article  PubMed  Google Scholar 

  28. Marder SR, Essock SM, Miller AL, Buchanan RW, Casey DE, Davis JM, Lieberman JA, Schooler NR, Covell N, Stroup S, Weissman EM, Wirshin DA, Hall CS, Pogach L, Pi-Sunyer X, Bigger JT, Friedman A, Kleinberg D, Yevich SJ, Davis B, Shon S (2004) Physical health monitoring of patients with schizophrenia. Am J Psychiatry 161 1334–1349

    Article  PubMed  Google Scholar 

  29. McCreadie R, Kelly C, Connelly M, Williams S, Baxter G, Lean M, Paterson JR (2005) Dietary improvement in people with schizophrenia. Br J Psychiatry 187:346–351

    Article  PubMed  Google Scholar 

  30. McCreadie RG on behalf of the Scottish Schizophrenia Lifestyle Group (2003) Diet, smoking and cardiovascular risk in people with schizophrenia. Br J Psychiatry 183:534–539

    Google Scholar 

  31. Menezes P, Johnson S, Thornicroft G, Marshall J, Prosser D, Bebbington P, Kuipers E (1996) Drug and alcohol problems among individuals with severe mental illnesses in South London. Br J Psychiatry 168:612–619

    Article  PubMed  CAS  Google Scholar 

  32. Mirza I, Phelan M (2002) Managing physical illness in people with severe mental illness. Hosp Med 63:535–539

    PubMed  Google Scholar 

  33. Morgan C, Dazzan P, Morgan K, Jones, Harrison G, Leff J, Murray R, Fearon P, on behalf of the AESOP Study Group (2006) First episode psychosis and ethnicity: initial findings from the AESOP study. World Psychiatry 5:40–46

    Google Scholar 

  34. Osborn D (2003) Participation in screening for cardiovascular risk by people with schizophrenia or similar mental illnesses: cross sectional study in general practice. Br Med J 326:1122–1123

    Article  CAS  Google Scholar 

  35. Osborn D, Nazareth I, King MB (2006) Risk for coronary heart disease in people with severe mental illness: cross sectional comparative study in primary care. Br J Psychiatry 188:271–277

    Article  PubMed  Google Scholar 

  36. Phelan M, Stradins L, Morrison S (2001) Physical health of people with severe mental illness. BMJ 322:443–444

    Article  PubMed  CAS  Google Scholar 

  37. Spitzer RL, Endicott J, Robins E (1978) Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 35:773–782

    PubMed  CAS  Google Scholar 

  38. Steinberg ML, Ziedonis DM, Krejci JA, Brandon TH (2004) Motivational interviewing with personalized feedback: a brief intervention for motivating smokers with schizophrenia to seek treatment for tobacco dependence. J Consult Clin Psychol 72:723–728

    Article  PubMed  Google Scholar 

  39. Strakowski S, Tohen M, Stoll A, Faedda G, Mayer P, Kolbrener M, Goodwin D (1993) Comorbidity in psychosis at first hospitalization. Am J Psychiatry 150:752–757

    PubMed  CAS  Google Scholar 

  40. Ziedonis DM, Kosten TR, Glazer WM, Frances RJ (1994) Nicotine dependence and schizophrenia. Hosp Community Psychiatry 45:204–206

    PubMed  CAS  Google Scholar 

  41. Zimmerman U, Kraus T, Himmerich H, Schuld A, Pollmakcher T (2003) Epidemiology, implications and mechanisms underlying drug-induced weight gain in psychiatric patients. J Psychiatric Res 37:93–220

    Google Scholar 

Download references

Acknowledgements

Our thanks to Dr. Annabel Nickol for her invaluable comments on the manuscript. The study was funded by the Medical Research Council and the NHS Executive.

Author information

Authors and Affiliations

  1. Sainsbury Centre for Mental Health, 34-138 Borough High Street, London, SE1 1LB, UK

    Chiara Samele

  2. Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, London, UK

    Maxine Patel, Jane Boydell & Robin Murray

  3. Health Services Research Dept., Institute of Psychiatry, London, UK

    Morven Leese

  4. Epidemiological and Liaison Psychiatry, Institute of Psychiatry, Weston Education Centre, London, UK

    Simon Wessely

Authors
  1. Chiara Samele
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maxine Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jane Boydell
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Morven Leese
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Simon Wessely
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Robin Murray
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chiara Samele.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Samele, C., Patel, M., Boydell, J. et al. Physical illness and lifestyle risk factors in people with their first presentation of psychosis. Soc Psychiat Epidemiol 42, 117–124 (2007). https://doi.org/10.1007/s00127-006-0135-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-006-0135-2

Key words

Search

Navigation