Medical comorbidity in women and men with schizophrenia: A population-based controlled study
Medical comorbidity in women and men with schizophrenia: A population-based controlled study
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DOI：
10.1111/j.1525-1497.2006.00563.x
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发表时间：
2006-11-01
影响因子：
5.7
通讯作者：
Woolson, Robert F.
中科院分区：
文献类型：
--
作者：
Carney, Caroline P.;Jones, Laura;Woolson, Robert F.
背景：患有持续性精神疾病的人有无法接受医疗服务的风险。为了提供适当的预防和初级保健，这是很重要的，以确定哪些慢性医疗条件是最常见的目的：我们研究了慢性医疗合并症的人与精神分裂症使用验证methodology.Design：回顾性分析纵向行政索赔数据从Wellmark蓝十字/蓝盾的爱荷华州。精神分裂症或情感障碍受试者（N= 1，074）和对照组（N= 726，262），1996年至2001年至少提出一次医疗服务索赔。根据精神科住院治疗、精神科医生诊断和门诊护理，病例受试者的精神分裂症是临床上最主要的精神病性障碍。对照组无任何精神并发症。使用Elixhauser Comorbid指数的修改版本，住院和门诊索赔被用来确定46种常见疾病的患病率。比值比（OR）进行了调整，年龄，性别，居住地，和非精神卫生保健利用率使用logistic regression.RESULTS：精神分裂症患者显着更有可能有1个或多个慢性疾病与对照组相比。调整或（95%置信区间[CI]）为2.62（2.09至3.28）甲状腺功能减退症，1.88（1.51至2.32）慢性阻塞性肺疾病，2.11（1.36至3.28）糖尿病并发症，7.54（3.55至15.99）丙型肝炎，4.21（3.25 ~ 5.44），尼古丁滥用/依赖为2.77（2.23 ~ 3.44）。结论：精神分裂症与大量慢性医疗负担有关。熟悉影响精神分裂症患者的条件可能有助于旨在为精神病患者提供医疗护理的计划。
BACKGROUND: Persons with persistent mental illness are at risk for failure to receive medical services. In order to deliver appropriate preventive and primary care for this population, it is important to determine which chronic medical conditions are most common.OBJECTIVE: We examined chronic medical comorbidity in persons with schizophrenia using validated methodologies.DESIGN: Retrospective analysis of longitudinal administrative claims data from Wellmark Blue Cross/Blue Shield of Iowa.PARTICIPANTS: Subjects with schizophrenia or schizoaffective disorder (N=1,074), and controls (N=726,262) who filed at least 1 claim for medical services, 1996 to 2001.MEASUREMENTS: Case subjects had schizophrenia as the most clinically predominant psychotic disorder, based on psychiatric hospitalization, psychiatrist diagnoses, and outpatient care. Controls had no claims for any psychiatric comorbidity. Using a modified version of the Elixhauser Comorbidity Index, inpatient and outpatient claims were used to determine the prevalence of 46 common medical conditions. Odds ratios (ORs) were adjusted for age, gender, residence, and nonmental health care utilization using logistic regression.RESULTS: Subjects with schizophrenia were significantly more likely to have 1 or more chronic conditions compared with controls. Adjusted OR (95% confidence interval [CI]) were 2.62 (2.09 to 3.28) for hypothyroidism, 1.88 (1.51 to 2.32) for chronic obstructive pulmonary disease, 2.11 (1.36 to 3.28) for diabetes with complications, 7.54 (3.55 to 15.99) for hepatitis C, 4.21 (3.25 to 5.44) for fluid/electrolyte disorders, and 2.77 (2.23 to 3.44) for nicotine abuse/dependence.CONCLUSIONS: Schizophrenia is associated with substantial chronic medical burden. Familiarity with conditions affecting persons with schizophrenia may assist programs aimed at providing medical care for the mentally ill.