Assessment of comorbid profile, quality of life and social functioning in patients with schizophrenia and schizotypal disorders
DOI:
https://doi.org/10.26641/2307-0404.2023.1.276043Keywords:
schizophrenia, schizotypal disorders, comorbid profile, quality of life, social functioningAbstract
One of the most common mental illnesses is schizophrenia and schizotypal disorders. According to the literature data, mortality among patients with schizophrenia is 1.5-2 times higher than among the general population. Patients with schizophrenia have a higher prevalence of cardiovascular disease, obesity, diabetes, osteoporosis in comparison with the general population. Such comorbid somatic diseases in the case of schizophrenia have a more acute course, a significant impact on the course of the underlying disease, the development of complications, decrease in quality of life and social functioning. The aim of the study was to study the presence and features of comorbidity, its impact on the quality of life and social functioning of patients with schizophrenia and schizotypal disorders. 100 patients were included in the study. They were divided into two groups: experimental (Group I) with schizophrenia and comparison (Group II), with other schizophrenic diseases, such as schizoaffective and schizotypal disorder. All patients were scaled according to the following methods: The Cumulative Illness Rating Scale (CIRS), Clinical Global Impression – Severity Scale (CGI-S), The Personal Social Performance Scale (PSP), CGI-S, and a short form of the questionnaire Medical Outcomes Study 36-Item Short-Form Health Status (SF-36). Charlson Index was also calculated for all patients included in the study. Due to CIRS, we detected undiagnosed comorbidity that aggravated the course of the underlying disease: 38% in Group I and 26% in Group II. The most common components in the structure of comorbidity in the patients with schizophrenia were diabetes mellitus, musculoskeletal diseases, cardiovascular diseases, non-alcoholic fatty liver disease (NAFLD). Patients with schizotypal disorders were more often diagnosed with peripheral vascular diseases, chronic lung diseases, chronic kidney diseases, and upper gastrointestinal tract disorders. A comprehensive approach to be important in the treatment of such patients. The nature and extent of comorbidity should be definitely taken into account. This will promote the compliance and improve the indicators in the examined category of patients.
References
GBD. Disease and Injuries Collaborators. Mental disorders – Level 2 cause. Global Health Metrics [Internet]. 2020 Oct 17 [cited 25 Dec 2022];396:5130. Available from: https://www.thelancet.com/pb-assets/Lancet/gbd/summaries/diseases/mental-disorders.pdf
United Nations. Transforming our world: the 2030 agenda for sustainable development [Internet]. Geneva: United Nations; 2015 [cited 25 Dec 2022]. Available from: https://sustainabledevelopment.un.org/content/documents/21252030%20Agenda%20for%20Sustainable%20Development%20web.pdf
Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M. Defining Comorbidity: Implications for Under¬standing Health and Health Services. The Annals of Family Medicine 2009;7:357-63. doi: https://doi.org/10.1370/afm.983
Aebi NJ, Caviezel S, Schaefert R, Meinlschmidt G, Schwenkglenks M, Fink G, et al. A qualitative study to investigate Swiss hospital personnel’s perceived importance of and experiences with patient’s mental-somatic multimorbidities. BMC Psychiatry. 2021;21. doi: https://doi.org/10.1186/s12888-021-03353-5
Hunt GE, Large MM, Cleary M, Lai HM, Saunders JB. Prevalence of comorbid substance use in schizophrenia spectrum disorders in community and clinical settings, 1990-2017: Systematic review and meta-analysis. Drug Alcohol Depend. 2018;191:234-58. doi: https://doi.org/10.1016/j.drugalcdep.2018.07.011
Tuch A. Somatisch-psychische Komorbidität in Schweizer Akutspitälern. Prävalenz und Inanspruchnahme. Obsan Bulletin [Internet]. 2018 [cited 25 Dec 2022];1. Available from: https://www.obsan.admin.ch/de/publikationen/2018-somatisch-psychische-komorbiditaet-schweizer-akutspitaelern
Mathers CD. History of global burden of disease assessment at the World Health Organization. Archives of Public Health. 2020;78. doi: https://doi.org/10.1186/s13690-020-00458-3
Charlson FJ, Ferrari AJ, Santomauro DF, Dimi-nic S, Stockings E, Scott JG, et al. Global Epidemiology and Burden of Schizophrenia: Findings From the Global Burden of Disease Study 2016. Schizophrenia Bulletin. 2018;44:1195-203. doi: https://doi.org/10.1093/schbul/sby058
WHO. Guidelines for the management of physical health conditions in adults with severe mental disorders [Internet]. Geneva; 2018 [cited 25 Dec 2022]. Available from: https://apps.who.int/iris/bitstream/handle/10665/275718/9789241550383-eng.pdf
Li Y, Yan LL, Ronsmans C, Wen H, Xu J, Wang D, et al. Excess mortality among patients with severe mental disorders and effects of community-based mental healthcare: a community-based prospective study in Sichuan, China. Bjpsych Open. 2021;7. doi: https://doi.org/10.1192/bjo.2021.46
Fisher K, Griffith LE, Gruneir A, Kanters D, Markle-Reid M, Ploeg J. Functional limitations in people with multimorbidity and the association with mental health conditions: Baseline data from the Canadian Longitudinal Study on Aging (CLSA). PLOS ONE 2021;16:e0255907. doi: https://doi.org/10.1371/journal.pone.0255907
Romash IR, Vynnyk MI. [Dynamics of indicators of social functioning in case of metabolic syndrome in patients with paranoid schizophrenia on the background of atypical neuroleptic agents application and improvement comorbidity.] Art of medicine. 2019;4(12):102-9. Ukrainian. doi: https://doi.org/10.36927/2079-0325-V27-is4-2019-11
Romash IR, Vynnyk MI. [Dynamics of Quality of Life Indices in Case of Metabolic Syndrome in Patients with Paranoid Schizophrenia on the Background of Atypical Neuroleptic Agents Application and Improvement of Comorbidity]. Ukrainskyi visnyk psykhonevrolohii. 2020;27,4(101):62-7. Ukrainian. doi: https://doi.org/10.36927/2079-0325-V27-is4-2019-11
Chang WC, Ng CM, Chan KN, et al. Psychiatric comorbidity in individuals at-risk for psychosis: Rela-tionships with symptoms, cognition and psychosocial functioning. Early Interv Psychiatry. 2021;15(3):616-23. doi: https://doi.org/10.1111/eip.12992
Sharma MP. Comorbidity of mental and physical disorders. Indian J Med Res. 2016 Nov;144(5):786-7. doi: https://doi.org/10.4103/0971-5916.203466
Smashna OYe. [Syndromogenesis of paranoid form of schizophrenia, comorbid with somatic pathology.] Ukrainskyi visnyk psykhonevrolohii. 2010;18(62):62-6. Ukrainian.
Pati S, Mahapatra P, Dwivedi R, et al. Multimor-bidity and Its Outcomes Among Patients Attending Psychiatric Care Settings: An Observational Study From Odisha, India. Front Public Health. 2021;8:616480. doi: https://doi.org/10.3389/fpubh.2020.616480
Ishigooka J, Nakagome K, Ohmori T, Iwata N, Inada K, Iga J, et al. Discontinuation and remission rates and social functioning in patients with schizophrenia receiving second‐generation antipsychotics: 52‐week evaluation of JUMPs, a randomized, open‐label study. Psychiatry and Clinical Neurosciences. 2022;76:22-31. doi: https://doi.org/10.1111/pcn.13304
Hudon C, Fortin M, Soubhi H. Abbreviated guide-lines for scoring the cumulative illness rating scale (CIRS) in family practice. J Clin Epidemiol. 2007;60:212.e1-4. doi: https://doi.org/10.1016/j.jclinepi.2005.12.021
Busner J, Targum SD. The clinical global impres-sions scale: applying a research tool in clinical practice. Psychiatry (Edgmont). 2007;4(7):28-37. PMID: 20526405.
Charlson ME, Pompei P, Ales KL, MacKen-zie CR. A new method of classifying prognostic comor-bidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-83. doi: https://doi.org/10.1016/0021-9681(87)90171-8
Mintser OP, Voronenko YuV, Vlasov VV. [Information technologies in health care and practical medicine: Training manual for students higher education incl. In 10 books. Book 5. Processing of clinical and experimental data in medicine]. Kyiv: Vyshcha shkola; 2003. 350 p. Ukrainian.
Burgess PM, Harris MG, Coombs T, Pirkis JE. A systematic review of clinician-rated instruments to assess adults’ levels of functioning in specialised public sector mental health services. Australian & New Zealand J Psychiatry. 2017;51:338-54. doi: https://doi.org/10.1177/0004867416688098
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