Massachusetts General Hospital Schizophrenia Program, Boston, USA.
Am J Med. 2012 Mar;125(3):223-30. doi: 10.1016/j.amjmed.2011.05.002.
Patients with schizophrenia represent a vulnerable population with high medical needs that are often missed or undertreated. Primary care providers have the potential to reduce health disparities experienced by this population and make a substantial difference in the overall health of these patients. This review provides primary care providers with a general understanding of the psychiatric and medical issues specific to patients with schizophrenia and a clinically practical framework for engaging and assessing this vulnerable patient population and assisting them in achieving optimal health. Initial steps in this framework include conducting a focused medical evaluation of psychosis and connecting patients with untreated psychosis to psychiatric care as promptly as possible. Given the significant contribution of cardiovascular disease to morbidity and mortality in schizophrenia, a top priority of primary care for patients with schizophrenia should be cardiovascular disease prevention and treatment through regular risk factor screening, appropriate lifestyle interventions, and other indicated therapies.
精神分裂症患者是一个弱势群体，他们有着很高的医疗需求，但这些需求往往得不到满足或得不到充分治疗。初级保健提供者有可能减少这一人群所经历的健康差距，并对这些患者的整体健康产生重大影响。本综述为初级保健提供者提供了对精神分裂症患者特定精神和医疗问题的一般了解，并为参与和评估这一弱势群体患者以及帮助他们实现最佳健康提供了一个临床实用框架。该框架的初始步骤包括对精神病进行重点医学评估，并尽快将未经治疗的精神病患者与精神科护理联系起来。鉴于心血管疾病对精神分裂症的发病率和死亡率有重大影响，精神分裂症患者的初级保健的首要任务应该是通过定期的危险因素筛查、适当的生活方式干预和其他有指征的治疗来预防和治疗心血管疾病。
