Schizophrenia is associated with a raised mortality due to both an increase in suicide and factors related to poor physical health. The increased rates of gastrointestinal, respiratory and cardiovascular disease in this population are likely to be due to high rates of smoking and obesity accompanied by a poor diet, lack of exercise and the side effects of medication. The evidence suggests that such risk factors in the schizophrenic population are largely ignored by the medical profession. Research to date has failed to address the health needs of this vulnerable population. Systematic research, with the aim of assessing the potential benefits of health improvement measures, should be a matter of priority.
BrownS. Excess mortality of schizophrenia. A meta-analysis. Br J Psychiatry1997;171: 502–8.
2.
AtkinsonJMCoiaDAGilmourWHHarperJP. The impact of education groups for people with schizophrenia on social functioning and quality of life. Br J Psychiatry1996; 16 8: 199–204.
3.
Scottish Intercollegiate Guidelines Network. Psychosocial Interventions in the Management of Schizophrenia. 1998;30.
4.
DalackGWHealyDJMeador-WoodruffJH. Nicotine dependence in schizophrenia: clinical phenomena and laboratory findings. Am J Psychiatry1998;155: 1490–1501.
5.
AddingtonJel-GuebalyNCampbellWHodginsDCAddingtonD. Smoking cessation treatment for patients with schizophrenia. AM J Psychiatry1998;155: 974–976.
6.
ZiedonisDMGeorgeTP. Schizophrenia and nicotine use: report of a pilot smoking cessation program and review of neurobiological and clinical issues. Schizophr Bull1997;23: 247–254.
7.
McEvoyJPFreudenreichOLevinEDRoseJE. Haloperidol increases smoking in patients with schizophrenia. Psychopharmacology (Berl)1995; 119: 124–126.
8.
McEvoyJFreudenreichOMcGeeMVanderZwaagCLevinERoseJ. Clozapine decreases smoking in patients with chronic schizophrenia. Biol Psychiatry1995;37: 550–552.
9.
SilverstoneTSmithGGoodallE. Prevalence of obesity in patients receiving depot antipsychotics. Br J Psychiatry1988; 153: 214–7.
10.
StantonM. Weight gain associated with neuroleptic medication: a review. Schizophr Bull1995;21: 463–472.
11.
BostonPFDursunSMReveleyMA. Cholesterol and mental disorder. Br J Psychiatry1996; 169: 682–689.
12.
HorrobinDF. Schizophrenia as a membrane lipid disorder which is expressed throughout the body. Prostaglandins Leukot Essent Fatty Acids1996;55: 3–7.
13.
HorrobinDFBennettCN. New gene targets related to schizophrenia and other psychiatric disorders: enzymes, binding proteins and transport proteins involved in phospholipid and fatty acid metabolism. Prostaglandins Leukot Essent Fatty Acids1999;60: 141–67.
14.
HorrobinDF. Abnormal membrane concentrations of 20 and 22-carbon essenltial fatty acids: a common link between risk factors and coronary and peripheral vascular disease. Prostaglandins Leukot Essent Fatty Acids1995;53: 385–396.
15.
LeafAWeberPC. Cardiovascular effects of n-3 fatty acids. N Engl J Med1988;318: 549–557.
16.
WalkerNPFoxHCWhalleyU. Lipids and schizophrenia [editorial]. Br J Psychiatry1999; 174: 101–4.
17.
McCreadieRMacdonaldEBlacklockCTilak-SinghDWilesDHallidayJPatersonJ. Dietary intake of schizophrenic patients in Nithsdale, Scotland: case-control study. Br Med J1998;317: 784–785.
18.
BrownSBirtwistleJRoeLThompsonC. The unhealthy lifestyle of people with schizophrenia. Psychol Med1999;29: 697–701.
19.
PeetM. Essential fatty acid deficiency in erythrocyte membranes from chronic schizophrenic patients, and the clinical effects of dietary supplementation. Prostaglandins Leukot Essent Fatty Acids1996;55: 71–5. Review.
20.
BurrMLFehilyAMGilbertHRogersSHollidayRMSweetnainPMElwoodPCDeadmanNM. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet1989, 2: 757–761.
21.
MukhedeeSDecinaPBocolaVSaraceniFScapicchioPL. Diabetes mellitus in schizophrenic patients. Compr Psychiatry1996;37: 68–73.
22.
LambertAEHenquinXOrciL. Chlorpromazine in malignant insulinoma. Br Med J1972;3: 701.
23.
HaggSJoelssonLMjorndalTSpigsetOOjaGDaffiqvistR. Prevalence of diabetes and impaired glucose tolerance in patients treated with clozapine compared with patients treated with conventional depot neuroleptic medications. J Clin Psychiatry1998;59: 294–299.
24.
KendrickTBurnsTFreelingPSibbaldB. Provision of care to general practice patients with disabling long-term mental illness: a survey in 16 practices. Br J Gen Pract1994;44: 301–305.
25.
LangFHForbesJFMurrayGDJohnstoneEC. Service provision for people with schizophrenia. 1. Clinical and economic perspective. Br J Psychiatry1997;171: 159–64.
26.
KendrickT. Cardiovascular and respiratory risk factors and symptoms among general practice patients with long-term mental illness. Br J Psychiatry1996;169: 733–739.
27.
BrughaTSWingJKSmithBL. Physical health of the long-term mentally ill in the community. Is there unmet need? Br J Psychiatry1989; 155: 777–81.
28.
BurnsTKendrickT. The primary care of patients with schizophrenia: a search for good practice. Br J Gen Pract1997;47: 515–520.
29.
SteptoeADohertySKendrickTRinkEHiltonS. Attitudes to cardiovascular health promotion among GPs and practice nurses. Fam Pract1999;16: 158–63.
