This research was supported by NIMH K08 MH01932-01A1 “Epidemiology of Cancer and Mental Illness in Rural Areas” (Dr. Carney). The authors thank Dr. Sheila Riggs of Wellmark Blue Cross Blue Shield of Iowa and South Dakota for granting access to the data used in this research.
Medical Comorbidity in Women and Men with Schizophrenia: A Population-Based Controlled Study
Version of Record online: 12 JUL 2006
Journal of General Internal Medicine
Volume 21, Issue 11, pages 1133–1137, November 2006
How to Cite
Carney, C. P., Jones, L. and Woolson, R. F. (2006), Medical Comorbidity in Women and Men with Schizophrenia: A Population-Based Controlled Study. Journal of General Internal Medicine, 21: 1133–1137. doi: 10.1111/j.1525-1497.2006.00563.x
- Issue online: 12 JUL 2006
- Version of Record online: 12 JUL 2006
- Received for publication September 28, 2004and in revised form February 5, 2005Accepted for publication May 23, 2006
- chronic medical condition;
- schizoaffective disorder
BACKGROUND: Persons with persistent mental illness are at risk for failure to receive medical services. In order to deliver appropriate preventive and primary care for this population, it is important to determine which chronic medical conditions are most common.
OBJECTIVE: We examined chronic medical comorbidity in persons with schizophrenia using validated methodologies.
DESIGN: Retrospective analysis of longitudinal administrative claims data from Wellmark Blue Cross/Blue Shield of Iowa.
PARTICIPANTS: Subjects with schizophrenia or schizoaffective disorder (N=1,074), and controls (N=726,262) who filed at least 1 claim for medical services, 1996 to 2001.
MEASUREMENTS: Case subjects had schizophrenia as the most clinically predominant psychotic disorder, based on psychiatric hospitalization, psychiatrist diagnoses, and outpatient care. Controls had no claims for any psychiatric comorbidity. Using a modified version of the Elixhauser Comorbidity Index, inpatient and outpatient claims were used to determine the prevalence of 46 common medical conditions. Odds ratios (ORs) were adjusted for age, gender, residence, and nonmental health care utilization using logistic regression.
RESULTS: Subjects with schizophrenia were significantly more likely to have 1 or more chronic conditions compared with controls. Adjusted OR (95% confidence interval [CI]) were 2.62 (2.09 to 3.28) for hypothyroidism, 1.88 (1.51 to 2.32) for chronic obstructive pulmonary disease, 2.11 (1.36 to 3.28) for diabetes with complications, 7.54 (3.55 to 15.99) for hepatitis C, 4.21 (3.25 to 5.44) for fluid/electrolyte disorders, and 2.77 (2.23 to 3.44) for nicotine abuse/dependence.
CONCLUSIONS: Schizophrenia is associated with substantial chronic medical burden. Familiarity with conditions affecting persons with schizophrenia may assist programs aimed at providing medical care for the mentally ill.