Ahti Johan, Kieseppä Tuula, Haaki Willehard, Suvisaari Jaana, Niemelä Solja, Suokas Kimmo, Holm Minna, Wegelius Asko, Kampman Olli, Lähteenvuo Markku, Paunio Tiina, Tiihonen Jari, Hietala Jarmo, Isometsä Erkki
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Hospital District of Helsinki and Uusimaa, Helsinki, Finland.
Schizophrenia (Heidelb). 2024 Dec 31;10(1):124. doi: 10.1038/s41537-024-00546-1.
Schizophrenia (SZ), schizoaffective disorder (SZA), bipolar disorder (BD), and psychotic depression (PD) are associated with premature death due to preventable general medical comorbidities (GMCs). The interaction between psychosis, risk factors, and GMCs is complex and should be elucidated. More research particularly among those with SZA or PD is warranted. We evaluated the association between registry-based psychotic disorders and GMC diagnoses in a large national sample of participants with different psychotic disorders. In addition, we examined whether body mass index (BMI) and smoking as risk factors for GMCs explain differences between diagnostic groups. This was a cross-sectional study of a clinical population of participants (n = 10,417) in the Finnish SUPER study. Registry-based diagnoses of psychotic disorders and hypertension, diabetes, chronic obstructive pulmonary disease (COPD), cancers, ischemic heart disease, and liver disorders were obtained. Participants' BMI and self-reported smoking were recorded. Total effect of diagnostic category adjusted for age and sex as well as direct effect including known risk factors was calculated using logistic regression. Regardless of diagnostic category, participants had high BMI (average 30.3 kg/m), and current smoking was common (42.4%). Diabetes and COPD were more common in SZ than in other diagnostic categories. The differences between psychotic disorders were not explained by obesity or smoking status only. Obesity and smoking were prevalent in all diagnostic categories of psychotic disorders, and continued efforts at prevention are warranted. Additional differences in GMC prevalence exist between psychotic disorders that are not explained by obesity and smoking.
精神分裂症（SZ）、分裂情感性障碍（SZA）、双相情感障碍（BD）和精神病性抑郁症（PD）与可预防的普通内科合并症（GMCs）导致的过早死亡相关。精神病、风险因素和GMCs之间的相互作用很复杂，需要阐明。尤其在患有SZA或PD的人群中进行更多研究很有必要。我们在一个包含不同精神病性障碍参与者的大型全国样本中，评估了基于登记的精神病性障碍与GMC诊断之间的关联。此外，我们研究了作为GMCs风险因素的体重指数（BMI）和吸烟是否能解释诊断组之间的差异。这是对芬兰SUPER研究中参与者（n = 10417）的临床人群进行的横断面研究。获得了基于登记的精神病性障碍以及高血压、糖尿病、慢性阻塞性肺疾病（COPD）、癌症、缺血性心脏病和肝脏疾病的诊断。记录了参与者的BMI和自我报告的吸烟情况。使用逻辑回归计算了调整年龄和性别后的诊断类别总效应以及包括已知风险因素的直接效应。无论诊断类别如何，参与者的BMI都很高（平均30.3 kg/m²），当前吸烟很常见（42.4%）。糖尿病和COPD在SZ中比在其他诊断类别中更常见。仅肥胖或吸烟状况并不能解释精神病性障碍之间的差异。肥胖和吸烟在所有精神病性障碍诊断类别中都很普遍，仍需继续努力进行预防。在未由肥胖和吸烟解释的精神病性障碍之间，GMC患病率还存在其他差异。
