ABSTRACT
INTRODUCTION: People with severe mental illness have greater risk of un-detected and inadequately treated medical disorders, adding up to the risk of premature death. This study investigated how chronic medical comorbidity evolved across the lifespan in schizophrenia and the associated impact on mortality. METHOD: A register-based retrospective nested case-control study was conducted, identifying incident cases of cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), cancer and diabetes, as well as mortality due to these diseases, across the lifespan in schizophrenia. SAMPLE: A schizophrenia cohort consisting of 4924 individuals aged 18-40â¯years registered with a diagnosis of schizophrenia (ICD-8: 295.0-3â¯+â¯295.9) during admission to a psychiatric hospital unit in 1970-79. Schizophrenia cases were age and gender matched with 22,597 controls in the general population. RESULTS: Rate ratio (RR) of CVD and cancer were similar to controls. The RR of COPD and diabetes were increased across the lifespan. The probability of having been diagnosed prior to dying from CVD, cancer, pulmonary diseases or diabetes was markedly reduced in schizophrenia cases compared to controls. The RR of all-cause mortality and mortality from CVD, COPD and diabetes remained elevated in all age groups in schizophrenia. Registration of medical comorbidity was associated with increased survival. CONCLUSION: Excess medical comorbidity persists across the lifespan and into older age. No age-related decrease in incidence of major chronic medical comorbidities in schizophrenia was found except for diabetes.
Subject(s)
Cardiovascular Diseases/epidemiology , Diabetes Mellitus/epidemiology , Neoplasms/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Schizophrenia/epidemiology , Adolescent , Adult , Age Factors , Cardiovascular Diseases/mortality , Case-Control Studies , Chronic Disease/epidemiology , Comorbidity , Denmark/epidemiology , Diabetes Mellitus/mortality , Female , Humans , Longevity , Longitudinal Studies , Male , Neoplasms/mortality , Pulmonary Disease, Chronic Obstructive/mortality , Registries , Retrospective Studies , Risk Factors , Schizophrenia/mortality , Young AdultABSTRACT
Personal attire is an important part of being a professional. This survey is an attempt to determine the patient's and psychiatrists view point about how a psychiatrist should dress to work. A human subjects research board approved survey of seven questions was offered to patients and a similar survey of nine questions was offered to psychiatrists. The replies obtained were combined and tabulated. One hundred patients and 77 psychiatrists responded to the survey. Both the patients and psychiatrists considered dress to be an important part of the doctor-patient relationship. The psychiatrists appear to be more concerned and critical about their dress as compared to patients.
