Gabilondo Andrea, Alonso-Moran Edurne, Nuño-Solinis Roberto, Orueta Juan F, Iruin Alvaro
Outpatient Mental Health Care Network, Osakidetza-Basque Health System, San Sebastian, Spain; Biodonosti Health Research Institute, San Sebastian, Spain.
Freelance Biostatistician, Bilbao, Spain.
J Psychosom Res. 2017 Feb;93:102-109. doi: 10.1016/j.jpsychores.2016.12.011. Epub 2016 Dec 23.
Using data from a large health dataset, the objectives are to describe the epidemiology of comorbidities with chronic physical conditions in schizophrenia, to identify gender profiles of illness and to discuss findings in the light of previous research.
The PREST health database was used which combines high quality and complementary data from numerous public health care resources in the Basque Country (Spain).
A total number of 2,255,406 patients were included in this study and 7331 had a diagnosis of schizophrenia. 55.6% of them had one comorbid condition and 29.3% had 2 or more (e.g. multiple comorbidities). Hypertension (16.8%) was the most prevalent diagnosed comorbid condition in these patients. The risk of having neuropsychiatric disorders including Parkinson (OR up to 47.89), infectious diseases (OR up to 3.31) or diabetes (OR2.23) was increased, while the risk of having cancer (OR down to 0.76) or some cardiovascular conditions (OR down to 0.63) was reduced. Women (both with and without schizophrenia) showed higher percentages of comorbidities than men. A cluster of respiratory diseases was found only in women with schizophrenia (not in men).
Results confirm partially previous findings and call for a more proactive and comprehensive approach to the health care of patients with schizophrenia. Specific profiles of risks for concrete disorders were identified which could be explained by selective underdiagnoses or higher exposition to risk factors in this group of patients. Results also suggest the need of a more gender oriented approach to health care in schizophrenia.
利用大型健康数据集的数据，描述精神分裂症患者慢性身体疾病合并症的流行病学特征，确定疾病的性别特征，并根据先前的研究对结果进行讨论。
使用了PREST健康数据库，该数据库整合了西班牙巴斯克地区众多公共卫生保健资源的高质量补充数据。
本研究共纳入2255406例患者，其中7331例被诊断为精神分裂症。其中55.6%的患者有一种合并症，29.3%的患者有两种或更多种合并症（如多种合并症）。高血压（16.8%）是这些患者中最常见的确诊合并症。患有包括帕金森病（比值比高达47.89）、传染病（比值比高达3.31）或糖尿病（比值比2.23）在内的神经精神疾病的风险增加，而患癌症（比值比降至0.76）或某些心血管疾病（比值比降至0.63）的风险降低。女性（无论是否患有精神分裂症）的合并症发生率均高于男性。仅在患有精神分裂症的女性中发现了一组呼吸道疾病（男性中未发现）。
结果部分证实了先前的研究结果，并呼吁对精神分裂症患者的医疗保健采取更积极、全面的方法。确定了具体疾病的特定风险特征，这可能是由于该组患者存在选择性诊断不足或接触风险因素较多所致。结果还表明，在精神分裂症的医疗保健中需要采取更注重性别的方法。
