Psychosocial consequences of physical health impairment in schizophrenia

Abstract

As well as the obvious medical consequences associated with physical health problems in individuals with schizophrenia, physical health problems lead to a number of psychosocial consequences - further contributing to the existing burden of schizophrenia itself. Weight gain is one that may have repercussions on both psychosocial and economic parameters. Weight gain can seriously impair quality of life through decreased functioning, social stigmatization, discrimination, and potential financial consequences. Obesity and being overweight appear to have the same impact on the self-esteem and well-being in people with schizophrenia as those in the general population, and it has been shown that patients who experienced recent weight gain had lower psychosocial adjustment and self-esteem compared with patients without weight change. However, patients with schizophrenia may be less capable of managing their weight via exercise and dietary interventions compared with the general population, and may, therefore, be more prone to non-compliance with a medication that induces weight gain. This may lead to exacerbation of the mental illness. Patients with schizophrenia may also experience other physical health problems owing to the tolerability profile of antipsychotic therapies, such as sexual dysfunction or extrapyramidal symptoms; such adverse effects also have the potential to impact on patient well-being, quality of life, functioning and compliance with therapy. Patients' perceptions and experience of antipsychotic treatments are also important as these can further impact on overall patient wellbeing. It is hoped that by increasing awareness of the psychosocial consequences of physical health impairment, we can move towards reducing the burden that patients face.