Table 2 Screening, diagnostic procedures and treatment of somatic co-morbidity

Tsay, 2007 [26].

Taiwan

1997–2001

Cohort study

97589 pts admitted for acute appendicitis

OR of perf. appendix: no mental disorder: 1.0; schizophr. pts: 2.83; affective psychosis: 1.15; other mental disorders: 1.58

Mentally ill patients are at a disadvantage in obtaining timely treatment for their physical diseases. Schizophrenic pts are the most vulnerable ones for obtaining timely surgical care.

Nasrallah, 2006[27].

USA

2003

Cohort study, baseline data from CATIE Schizophrenia Trial

1460 schizophr. pts 18–65 years of age

Prevalence of pts with untreated DM: 30.2%; pts with untreated hypertension: 62.4%; pts with untreated dyslipidemia: 88.0%

There is a high likelihood that metabolic disorders are untreated in schizophr. pts.

Roberts, 2007[28].

UK

April 1998–Dec 2000

Case-matched retrospective review.

195 schizophr. pts vs. 390 matched asthma pts vs. 390 matched controls

OR of blood pressure records 0.51 (vs. asthma pts); OR of cholesterol records 0.50 (vs. asthma pts); OR of blood pressure records 0.68 (vs. controls); OR of cholesterol records 0.58 (vs. controls)

Schizophr. pts are less likely to receive some important general health checks than patients without schizophrenia.

Wright, 2006[29].

UK

Not mentioned

Qualitative research

31 SMI pts, 8 GP's and 2 NP's, 25 mental health workers

Identified problems are the lack of familiarity with SMI and antipsychotic side effects in general practice, poor communication of physical health issues to the CMHT, lack of knowledge regarding CHD risk factor screening, and difficulties in interpreting screening results and implementing appropriate interventions in secondary care

Management of physical health care for people with SMI requires complex solutions that cross the primary-secondary care interface.

Osborn, 2003[30]. UK

Not mentioned

Experiment

182 psychotic pts

313 controls

OR for pts participating in cardiovascular risk screening: 0.76. Psychotic pts consulted their GP more often (mean difference 1.8)

Interest in risk assessment was similar to those in other community research involving blood tests.

Beecroft, 2001[31]. UK

Not mentioned

Interviews

309 randomly selected pts from a sample of 566 psychotic pts

Pts who visited their GP within the last 6 months were more often (83% vs. 50%) satisfied with the amount and type of service provided for their physical needs

Patients with SMI should be encouraged to see their GPs. There is a strong argument for a routine annual check up of the severely mentally ill by their GPs.