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Open Access Research article

Incident somatic comorbidity after psychosis: results from a retrospective cohort study based on Flemish general practice data

Carla Truyers1*, Frank Buntinx12, Jan De Lepeleire1, Marc De Hert3, Ruud Van Winkel3, Bert Aertgeerts1, Stefaan Bartholomeeusen1 and Emmanuel Lesaffre4

Author Affiliations

1 Department of General Practice, Katholieke Universiteit Leuven, Leuven, Belgium

2 Research Institute Caphri, Maastricht University, Maastricht, The Netherlands

3 University Psychiatric Center campus Kortenberg, Leuvensesteenweg 517, 3070 Kortenberg, Belgium

4 L-Biostat, Katholieke Universiteit Leuven, Leuven, Belgium; Department of Biostatistics, Erasmus University Rotterdam, Rotterdam, The Netherlands

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BMC Family Practice 2011, 12:132  doi:10.1186/1471-2296-12-132

Published: 29 November 2011

Abstract

Background

Psychotic conditions and especially schizophrenia, have been associated with increased morbidity and mortality. Many studies are performed in specialized settings with a strong focus on schizophrenia. Somatic comorbidity after psychosis is studied, using a general practice comorbidity registration network.

Methods

Hazard ratios are presented resulting from frailty models to assess the risk of subsequent somatic disease after a diagnosis of psychosis compared to people without psychosis matched on practice, age and gender. Diseases studied are cancer, physical trauma, diabetes mellitus, gastrointestinal disorders, joint disorders, irritable bowel syndrome, general infections, metabolic disorders other than diabetes, hearing and vision problems, anemia, cardiovascular disease, alcohol abuse, lung disorders, mouth and teeth problems, sexually transmitted diseases.

Results

Significant higher risks after a diagnosis of psychosis were found for the emergence of diabetes, physical trauma, gastrointestinal disorders, alcohol abuse, chronic lung disease and teeth and mouth problems. With regard to diabetes, by including the type of antipsychotic medication it is clear that the significant overall effect was largely due to the use of atypical antipsychotic medication. No significant higher risk was seen for cancer, joint conditions, irritable bowel syndrome, general infections, other metabolic conditions, hearing/vision problems, anaemia, cardiovascular disease or diabetes, in case no atypical antipsychotic medication was used.

Conclusion

Significantly higher morbidity rates for some somatic conditions in patients with psychosis are apparent. People with a diagnosis of psychosis benefit from regular assessments for the emergence of somatic disorders and risk factors, including diabetes in case of atypical antipsychotic medication.