Comorbidities with chronic physical conditions and gender profiles of illness in schizophrenia. Results from PREST, a new health dataset

Abstract

Objective: Using data from a large health dataset, the objectives are to describe the epidemiology of comorbidities with chronic physical conditions in schizophrenia, to identify gender profiles of illness and to discuss findings in the light of previous research.

Methods: The PREST health database was used which combines high quality and complementary data from numerous public health care resources in the Basque Country (Spain).

Results: A total number of 2,255,406 patients were included in this study and 7331 had a diagnosis of schizophrenia. 55.6% of them had one comorbid condition and 29.3% had 2 or more (e.g. multiple comorbidities). Hypertension (16.8%) was the most prevalent diagnosed comorbid condition in these patients. The risk of having neuropsychiatric disorders including Parkinson (OR up to 47.89), infectious diseases (OR up to 3.31) or diabetes (OR2.23) was increased, while the risk of having cancer (OR down to 0.76) or some cardiovascular conditions (OR down to 0.63) was reduced. Women (both with and without schizophrenia) showed higher percentages of comorbidities than men. A cluster of respiratory diseases was found only in women with schizophrenia (not in men).

Conclusions: Results confirm partially previous findings and call for a more proactive and comprehensive approach to the health care of patients with schizophrenia. Specific profiles of risks for concrete disorders were identified which could be explained by selective underdiagnoses or higher exposition to risk factors in this group of patients. Results also suggest the need of a more gender oriented approach to health care in schizophrenia.

Keywords: Comorbidity; Consultation-liason; Epidemiology; Multimorbidity; Primary care; Schizophrenia.