Abstract

Introduction: Comorbidity between mental disorders and physical illnesses is the rule rather than the exception. Approaches to study the impact of comorbidity become challenging also due to lack of consensus about how to define and measure the concept of comorbidity. The aim of the present study was to evaluate the clinical profile of medical comorbidity among a group of local chronic elderly schizophrenic patients to see their prevalence and physiognomies.

Methods: while the geriatric section of Razi psychiatric hospital had been selected as the field of investigation, all elderly schizophrenic patients, who have been hospitalized there for lifelong, had been selected as accessible sample and surveyed with respect to recorded checkups and comorbid medical diagnoses. Psychiatric diagnosis was in essence based on ‘Diagnostic and Statistical Manual of Mental Disorders’, 5th edition (DSM-5) and medical diagnosis was principally based on ‘International Classification of Diseases’, 10th edition.

Results: Assessment had been performed on 168 aged schizophrenic patients (≥65 years old), including 101 men and 67 women. According to the results, 89% (n=151) of the elderly patients had some kind of registered non-psychiatric co-morbidity, which was meaningful higher than the frequency of comorbidity among a senior group of local residents. Amongst recorded co-morbidities: falls, hypertension and osteoarthritis were the most prevalent comorbidities with a frequency around 48.8%, 44.6% and 39.2%, respectively. Hypertension, renal disease and malnutrition were significantly more prevalent among male patients (p<0.0000, p<0.0045 and p< 0.0018, in turn) and hyponatremia, aspiration/ asphyxiation and seizure were meaningfully more prevalent among female patients (p<0.0075, p<0.0000 and p<0.0009, one-to-one). As stated by the findings and in comparison, with the senior group of local people, while diabetes, renal diseases and malnutrition were significantly more frequent, coronary artery disease, gastrointestinal disorder and osteoarthritis were significantly less frequent among the present sample of elderly schizophrenic patients.

Conclusion: While in comparison with a senior group of local people, the rate of medical comorbidities, particularly diabetes, renal diseases and malnutrition, were significantly higher in chronic elderly schizophrenic patients, a significant difference; as well, was the interrelated items between male and female patients, which demands further methodical and gender-based studies to define proper care and interventions for this vulnerable group of patients.

Keywords: Schizophrenia; Psychiatric disorders; Medical comorbidity; Elderly mental patients; Senior group of people; Chronic patients.