Schizophrenia Patients Suffer More Hospital Injuries

People with schizophrenia are more likely than others to sustain medical injuries during non-psychiatric hospital stays, a large national study finds.

“These findings confirm that medical and surgical hospitalizations are an at-risk time for this group, and a national problem,” said lead study author Elizabeth Khaykin, at the Department of Mental Health at Bloomberg Johns Hopkins School of Public Health.

Schizophrenia affects about 1.1 percent of U.S. adults, according to the National Institute of Mental Health. The new study appears in the July/August issue of the journal General Hospital Psychiatry.

Khaykin and her colleagues studied hospital discharge records from 3,605 U.S. hospitals from 2002 to 2007 using the Nationwide Inpatient Sample, covering 269,387 hospitalizations of people with schizophrenia and more than 37 million hospitalizations of people without schizophrenia.

The data showed that people diagnosed with schizophrenia have a higher risk of having medical injuries - including decubitus ulcers (bedsores), sepsis and infection - while they are hospitalized than do patients without schizophrenia. The odds of having postoperative respiratory failure were almost twice as high.

For example, there were 24.2 incidences of postoperative respiratory failure per 1,000 hospitalizations for those with schizophrenia compared with 9.2 incidences for those without. In addition, there were 36.6 incidences of bedsores per 1,000 hospitalizations for those with schizophrenia compared to 27.7 per 1,000 people without.

“The combination of medical illness, medications that patients with schizophrenia already take and communication gaps put them at risk for the elevated patient safety events that we observed,” Khaykin said.

“It does not surprise us that this study found various ways in which people with schizophrenia were not receiving optimum health care,” said Chris Koyanagi, policy director at the Bazelon Center for Mental Health Law, in Washington.

“We hear anecdotal reports from individuals that their primary care providers and medical specialists do not always listen to their physical complaints seriously, but write them off as part of their mental illness,” she said.