Home » Disorders » Schizophrenia » Psychosis and Cardiovascular Disease

Psychosis and Cardiovascular Disease

The relationship between mental illness and cardiovascular disease or cancer has been debated for years. A large British study finds that people with schizophrenia, schizoaffective disorder, bipolar disorder and delusional disorder are more likely to die from coronary heart disease and stroke, but not cancer — than those without mental illness.

The report is found in the February issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

Lifestyle, diet and overall physical health are a concern among those with severe mental illnesses, according to background information in the article. The adverse effects of antipsychotic medication, along with smoking, lifestyle factors and poverty, may contribute to physical illness in this population.

David P.J. Osborn, Ph.D., and colleagues at the Royal Free and University College Medical School, London, selected 46,136 individuals with severe mental illness (including schizophrenia, schizoaffective disorder, bipolar disorder and delusional disorder) and 300,426 without mental illness from a nationally representative database in the United Kingdom.

The researchers compared the two group’s death rates from coronary heart disease, stroke and the seven most common types of cancer in the United Kingdom—respiratory, colorectal, breast, prostate, stomach, esophageal and pancreatic cancer.

“We chose to study death rates rather than incidence rates, because mortality is the most robust outcome since it includes diagnoses made post-mortem,” the authors write.

Over a follow-up period of at least six months, individuals of all ages were significantly more likely to die from coronary heart disease and stroke if they had a severe mental illness.

Those with severe mental illness age 18 to 49 were 3.22 times as likely to die from heart disease and 2.53 times as likely to die from stroke; those age 50 to 75 were 1.86 times more likely to die from heart disease and 1.89 times more likely to die from stroke, and those older than 75 were 1.05 times as likely to die from heart disease and 1.34 times as likely to die from stroke.

The rates did not change significantly after the researchers adjusted for smoking rates and social deprivation, both of which contribute to the risk for heart disease. The use of antipsychotic medication, however, did have an effect.

“People with severe mental illness who were not prescribed any antipsychotics were at increased risk of coronary heart disease and stroke than controls, whereas those prescribed such agents were at even greater risk,” the authors write.

“Those receiving the higher doses were at greatest risk for death from both coronary heart disease and stroke.”

“With the exception of respiratory tumors, people with severe mental illness were not at increased risk of dying from the seven most common cancers in the United Kingdom,” they continue.

“However, our data did not confirm other evidence that they were protected from cancers.”

Additional research is needed to help prevent cardiovascular disease and death among those with severe mental illness, the authors conclude. “Clinically, a holistic approach to the care of people with severe mental illness is still frequently overlooked,” they write.

“Such an approach requires monitoring for somatic conditions and demands effective communication between primary and secondary care to provide coherent physical health care.”

Source: JAMA and Archives Journals

Psychosis and Cardiovascular Disease

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Psychosis and Cardiovascular Disease. Psych Central. Retrieved on June 19, 2018, from https://psychcentral.com/news/2007/02/08/psychosis-linked-with-cardiovascular-death/608.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.