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Chapter 13 - Physical Health of Patients with Schizophrenia

Management of Antipsychotic-Induced Side Effects and Treatment of Comorbid Somatic Conditions

Published online by Cambridge University Press:  01 February 2024

Andrea Fiorillo
Affiliation:
University of Campania “L. Vanvitelli”, Naples
Peter Falkai
Affiliation:
Ludwig-Maximilians-Universität München
Philip Gorwood
Affiliation:
Sainte-Anne Hospital, Paris
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Summary

Schizophrenia is associated with increased risk of somatic comorbities and reduced life expectancy [1]. At the same time, available data suggests that continuous antipsychotic treatment decreases the mortality rate of schizophrenia patients [2,3]. Since both short- and long-term administration of antipsychotics induce numerous physical side effects, it is important that low – or the minimum effective – doses are used [4]. Patients diagnosed with schizophrenia and treated with antipsychotics frequently also suffer from psychiatric (e.g., depression, anxiety, insomnia) and somatic (e.g., cardiovascular diseases, infections, metabolic disorders) comorbidities. While often underreported and undertreated, somatic comorbidities represent a severe burden for schizophrenia patients [5]. In a Hungarian nationwide register-based study, researchers showed that patients with schizophrenia (n = 65,169) had a statistically significantly higher all-cause mortality rate than control participants (risk ratio = 2,4; P < 0.0001) [1]. The most prevalent comorbidities in this study were cerebro- and cardiovascular diseases (53.7%), followed by acute lower respiratory infections and other infections [1].

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