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Chronic physical illnesses in patients with schizophrenia spectrum disorders are independently associated with higher rates of psychiatric rehospitalization; a cross-sectional study in Croatia

Published online by Cambridge University Press:  23 March 2020

I. Filipcic ,
I. Simunovic Filipcic ,
E. Ivezic ,
K. Matic ,
N. Tunjic Vukadinovic ,
S. Vuk Pisk ,
D. Bodor ,
Z. Bajic ,
M. Jakovljevic  and
N. Sartorius
I. Filipcic*
Affiliation:
Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia School of Medicine, University of Zagreb, Zagreb, Croatia
I. Simunovic Filipcic
Affiliation:
Department of psychological medicine, University Hospital Center Zagreb, Zagreb, Croatia
E. Ivezic
Affiliation:
Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia
K. Matic
Affiliation:
Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia
N. Tunjic Vukadinovic
Affiliation:
Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia
S. Vuk Pisk
Affiliation:
Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
D. Bodor
Affiliation:
Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia
Z. Bajic
Affiliation:
Biometrika Healthcare Research, Zagreb, Croatia
M. Jakovljevic
Affiliation:
School of Medicine, University of Zagreb, Zagreb, Croatia Department of psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
N. Sartorius
Affiliation:
Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
*
*Corresponding author. Psychiatric hospital “Sveti Ivan”, Jankomir 11, pp68, 10 090 Zagreb, Croatia. E-mail address:igor.filipcic@pbsvi.hr (I. Filipcic).
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Abstract

Background:

Increased physical morbidity in patients with schizophrenia spectrum disorders (SSDs) is well documented. However, much less is known about the association between somatic comorbidities and psychosis treatment outcomes.

Subjects and methods:

This cross-sectional study, nested within the larger frame of a prospective cohort study, was done in 2016 at Psychiatric Hospital Sveti Ivan, Zagreb, Croatia. Data were collected on a consecutive sample of 301 patients diagnosed with schizophrenia spectrum disorders who achieved a stable therapeutic dosage. Key outcome was the number of psychiatric rehospitalizations since diagnosis of the primary psychiatric illness. Predictors were number of physical and psychiatric comorbidities. By robust regression, we controlled different clinical, sociodemographic, and lifestyle confounding factors.

Results:

The number of chronic somatic comorbidities was statistically significantly associated with a larger number of psychiatric rehospitalizations, even after the adjustment for number of psychiatric comorbidities and large number of other clinical, sociodemographic, and lifestyle variables.

Conclusions:

Chronic somatic comorbidities are associated with higher rates of psychiatric rehospitalization independently of psychiatric comorbidities and other clinical, sociodemographic, and lifestyle factors. Therefore, to treat psychosis effectively, it may be necessary to treat chronic somatic comorbidities promptly and adequately. Chronic somatic comorbidities should be considered equally important as the SSD, and should be brought to the forefront of psychiatric treatment and research with the SSD as one entity. The integrative approach should be the imperative in clinical practice.

Keywords

SchizotypalDelusionalMedical comorbidityPsychiatric comorbidityRehospitalizationSevere mental illness
Type
Original article
Information
European Psychiatry , Volume 43 , June 2017 , pp. 73 - 80
Copyright
Copyright © European Psychiatric Association 2017

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Footnotes

1

Igor Filipcic and Ivona Simunovic Filipcic have equally contributed to the paper (shared first authorship).

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