Comorbid Psychiatric and Physical Disorders

Abstract

Schizophrenia is a complex, disabling mental illness with an early onset and chronic course. The course of the illness as well as the prognosis is further complicated by the presence of psychiatric and physical comorbidities. Patients with schizophrenia have a reduced life expectancy, and suicide alone is responsible for a significant proportion of this increased mortality. Substance use disorders also significantly add to the morbidity, along with anxiety and depressive disorders which are commonly seen in this population. They also have a much higher incidence of type 2 diabetes mellitus, cardiovascular disease, and pulmonary disease compared to that of the general population. Some of these disorders may predate the schizophrenia onset, and some may emerge post the onset. The social withdrawal and cognitive deficits associated with the condition could hinder early detection and clinical management of comorbidities; therefore, it is imperative that the mental health team remains vigilant in screening these patients for potentially preventable coexisting disorders. In this chapter, we review the evidence regarding the psychiatric and physical comorbidities in patients with schizophrenia, including possible etiological models, management guidelines, and strategies in reducing barriers to health care in patients with schizophrenia.