Goldman L S
Department of Psychiatry, University of Chicago, Ill 60637-1470, USA.
J Clin Psychiatry. 1999;60 Suppl 21:10-5.
Research into the relationship between physical illness and schizophrenia has revealed that patients with schizophrenia may be at decreased risk for certain disorders, such as rheumatoid arthritis and allergies, but at increased risk for others, including substance abuse and polydipsia. Although such knowledge may ultimately help determine the underlying causes of schizophrenia, the principal concern of practicing clinicians should be to diagnose and treat medical comorbidity in individual patients. Nearly 50% of patients with schizophrenia have a comorbid medical condition, but many of these illnesses are misdiagnosed or undiagnosed. A fragmented health care system, lack of access to care, patient inability to clearly appreciate or describe a medical problem, and patient reluctance to discuss such problems all contribute to the lack of attention to medical problems in patients with schizophrenia. Psychiatrists and primary care practitioners who treat patients with schizophrenia should make an effort to uncover medical illnesses by using a structured interview or routine physical examination whenever a patient is seen for care.
对身体疾病与精神分裂症之间关系的研究表明，精神分裂症患者患某些疾病（如类风湿性关节炎和过敏症）的风险可能降低，但患其他疾病（包括药物滥用和烦渴症）的风险会增加。尽管这些知识最终可能有助于确定精神分裂症的潜在病因，但临床医生的主要关注点应该是诊断和治疗个体患者的合并症。近50%的精神分裂症患者患有合并症，但其中许多疾病被误诊或未被诊断出来。医疗保健系统碎片化、难以获得医疗服务、患者无法清晰认识或描述医疗问题以及患者不愿讨论此类问题，这些都导致了对精神分裂症患者医疗问题的关注不足。治疗精神分裂症患者的精神科医生和初级保健医生应努力通过结构化访谈或常规体格检查来发现医疗疾病，只要有患者前来就诊。
