Filipcic I, Simunovic Filipcic I, Ivezic E, Matic K, Tunjic Vukadinovic N, Vuk Pisk S, Bodor D, Bajic Z, Jakovljevic M, Sartorius N
Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
Department of psychological medicine, University Hospital Center Zagreb, Zagreb, Croatia.
Eur Psychiatry. 2017 Jun;43:73-80. doi: 10.1016/j.eurpsy.2017.02.484. Epub 2017 Mar 10.
Increased physical morbidity in patients with schizophrenia spectrum disorders (SSDs) is well documented. However, much less is known about the association between somatic comorbidities and psychosis treatment outcomes.
This cross-sectional study, nested within the larger frame of a prospective cohort study, was done in 2016 at Psychiatric Hospital Sveti Ivan, Zagreb, Croatia. Data were collected on a consecutive sample of 301 patients diagnosed with schizophrenia spectrum disorders who achieved a stable therapeutic dosage. Key outcome was the number of psychiatric rehospitalizations since diagnosis of the primary psychiatric illness. Predictors were number of physical and psychiatric comorbidities. By robust regression, we controlled different clinical, sociodemographic, and lifestyle confounding factors.
The number of chronic somatic comorbidities was statistically significantly associated with a larger number of psychiatric rehospitalizations, even after the adjustment for number of psychiatric comorbidities and large number of other clinical, sociodemographic, and lifestyle variables.
Chronic somatic comorbidities are associated with higher rates of psychiatric rehospitalization independently of psychiatric comorbidities and other clinical, sociodemographic, and lifestyle factors. Therefore, to treat psychosis effectively, it may be necessary to treat chronic somatic comorbidities promptly and adequately. Chronic somatic comorbidities should be considered equally important as the SSD, and should be brought to the forefront of psychiatric treatment and research with the SSD as one entity. The integrative approach should be the imperative in clinical practice.
精神分裂症谱系障碍（SSDs）患者身体发病率增加已有充分记录。然而，关于躯体合并症与精神病治疗结果之间的关联，人们所知甚少。
这项横断面研究嵌套在一项前瞻性队列研究的更大框架内，于2016年在克罗地亚萨格勒布的斯韦蒂·伊万精神病医院进行。收集了连续301例诊断为精神分裂症谱系障碍且达到稳定治疗剂量患者的数据。主要结局是自原发性精神疾病诊断以来的精神科再住院次数。预测因素是躯体和精神科合并症的数量。通过稳健回归，我们控制了不同的临床、社会人口学和生活方式混杂因素。
即使在对精神科合并症数量以及大量其他临床、社会人口学和生活方式变量进行调整之后，慢性躯体合并症的数量在统计学上仍与更多的精神科再住院次数显著相关。
慢性躯体合并症与更高的精神科再住院率相关，独立于精神科合并症以及其他临床、社会人口学和生活方式因素。因此，为有效治疗精神病，可能有必要及时且充分地治疗慢性躯体合并症。慢性躯体合并症应被视为与精神分裂症谱系障碍同等重要，并且应作为一个整体，在精神分裂症谱系障碍的精神病治疗和研究中占据前沿位置。综合治疗方法应成为临床实践中的当务之急。
