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Friday, November 16, 2007

Psychiatric Patients treated too late for their somatic illness


Psychiatric patients are treated relatively late for their somatic illness. Especially patients with Schizophrenia suffer complications from their somatic illness due to late interventions.

This conclusion is based on a research from different universities in Taiwan and the US. The researchers studied all patients admitted to hospitals in Taiwan during a four year period. They looked at acute appendicitis. This method is used earlier to estimate the accessibility of hospitals and hospital care.

The sample consisted of almost 100.000 patients. They looked at the differences in the course of the illness between patients with or without a psychiatric illness such as Schizophrenia and Depression. They also looked at confounding factors such as age, gender, ethnicity, socioeconomic status and kind of hospital.

In patients without a psychiatric illness, about 25% suffered from a burst appendicitis, a severe complication of acute appendicitis. In patients with a psychiatric disorder this percentage was 45%. When taking the confounding factors in account the risk for a burst appendicitis was only significantly higher for patients with Schizophrenia. They had a 3 times higher risk compared to patients without a psychiatric disease.


Besides doctors not always being acquainted with these patients other factors play a role in this problem:


  • Patients with Schizophrenia are often paranoid and anxious.

  • They also have trouble functioning socially.

  • They usually are less able to express their complaints.

  • They notice pain far more less than others.



Patients with Schizophrenia have a shorter life expectancy due to suicide and accidents, but also due to life threatening somatic illnesses.

Of patients with a major mental illness, schizophrenic patients may be the most vulnerable ones for obtaining timely surgical care.


Article discussed:
Research article
Disparities in appendicitis rupture rate among mentally ill patients
Jen-Huoy Tsay, Cheng-Hua Lee, Yea-Jen Hsu, Pen-Jen Wang, Ya-Mei Bai, Yiing-Jenq Chou and Nicole Huang.
BMC Public Health 2007, 7:331doi:10.1186/1471-2458-7-331
Blogging on Peer-Reviewed Research



2 comments:

Jan Martens said...

Hey Doc,

I think you missed one o in to. To should be too.

Dr. Shock said...

Yep you're right, thanks.
Regards Dr Shock