Orellana Gricel, Rodríguez Matías, González Nicolás, Durán Eduardo
Departamento de Psiquiatría, Sede Oriente, Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Departamento de Psiquiatría, Sede Sur., Escuela de Medicina. Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2017 Aug;145(8):1047-1053. doi: 10.4067/s0034-98872017000801047.
The life expectancy of patients with schizophrenia (SCH) is 11 to 20 years less than the general population. There is an association between SCH and various diseases and chronic conditions, highlighting the cardio-metabolic diseases. This association has been attributed to the use of antipsychotics, however, evidence has also shown intrinsic susceptibility of schizophrenic patients the development of chronic conditions. This review aims to update knowledge about chronic conditions such as cardiometabolic risk and sleep, bone and kidney disorders related to SCH. These patients have a high prevalence of risk behaviors, including smoking and poor diet. They have a worse metabolic profile than the general population and a greater likelihood of developing metabolic syndrome, diabetes and cardiovascular disease. SCH has also been associated with other chronic diseases such as osteoporosis and chronic kidney disease. The high prevalence of these comorbidities in schizophrenic population is not explained solely by the antipsychotic treatment, therefore intrinsic mechanisms associated to SCH are postulated to be associated with these conditions. This new information requires a change in the multidisciplinary medical approach for the study and management of schizophrenic patients.
精神分裂症(SCH)患者的预期寿命比普通人群短11至20年。SCH与各种疾病和慢性疾病之间存在关联,其中以心脏代谢疾病最为突出。这种关联一直被归因于抗精神病药物的使用,然而,有证据也表明精神分裂症患者本身就易患慢性疾病。本综述旨在更新关于与SCH相关的慢性疾病的知识,如心脏代谢风险、睡眠、骨骼和肾脏疾病。这些患者存在高风险行为的患病率,包括吸烟和不良饮食。他们的代谢状况比普通人群更差,患代谢综合征、糖尿病和心血管疾病的可能性更大。SCH还与其他慢性疾病如骨质疏松症和慢性肾脏病有关。精神分裂症患者中这些合并症的高患病率不能仅用抗精神病药物治疗来解释,因此推测与SCH相关的内在机制与这些疾病有关。这一新信息要求在对精神分裂症患者的研究和管理中改变多学科医疗方法。