Hiram Consulting Ltd, Pontefract, UK.
J Psychopharmacol. 2010 Nov;24(4 Suppl):37-50. doi: 10.1177/1359786810384639.
The 2009 World Health Organization report on global health risks identifies hypertension, smoking, raised glucose, physical inactivity, obesity and dyslipidaemia, in that order, as being the top six modifiable global mortality risk factors. Patients with schizophrenia have high levels of all these risk factors. There are a small number of studies showing that interventions can improve these, but prospective long-term studies are not available to show their impact on mortality. A number of studies are now supporting the view that patients with schizophrenia may be dying prematurely as they are not gaining access to or receiving the same medical care as the general population. The literature now suggests that low cardiorespiratory fitness and muscle strength are among the strongest predictors of all-cause mortality in the general population. Smoking is still one of the largest risk factors for premature all-cause mortality. The literature supports the thesis that lifestyle intervention programmes addressing exercise, smoking cessation and compliance with medication are likely to have significant impact on mortality in schizophrenia. It will be important to ensure that all patients with schizophrenia have advocates to ensure appropriate treatment and avoid prejudice, and to establish fitness standards in schizophrenia.
2009 年世界卫生组织全球卫生风险报告将高血压、吸烟、高血糖、缺乏身体活动、肥胖和血脂异常列为可改变的全球死亡风险因素前六位。精神分裂症患者有很高的这些风险因素水平。有少数研究表明干预措施可以改善这些因素，但没有前瞻性的长期研究表明它们对死亡率的影响。现在有许多研究支持这样一种观点，即精神分裂症患者可能因无法获得或接受与一般人群相同的医疗保健而过早死亡。文献表明，低心肺功能和肌肉力量是一般人群全因死亡率的最强预测因素之一。吸烟仍然是导致全因过早死亡的最大风险因素之一。文献支持这样一种论点，即针对运动、戒烟和药物依从性的生活方式干预方案可能对精神分裂症的死亡率产生重大影响。确保所有精神分裂症患者都有支持者来确保他们获得适当的治疗、避免偏见，并在精神分裂症中建立健康标准非常重要。
