golnaz feyzzadeh

Patients with schizophrenia receive psychiatric medications for many years, and their comorbid profile in old age remains unclear. Moreover, their pattern of non-psychiatric medicine use is of importance. Rehabilitation is crucial in patients with schizophrenia because it improves their strengths and life skills to live independently. These issues are essential in terms of polypharmacy among them, and its associated adverse effects. 

The present cross-sectional study investigated 131 patients with schizophrenia referring to Razi Hospital who were selected by a convenience sampling method. The subjects’ medical records were evaluated in terms of comorbid disorders and non-psychiatric medicine use patterns. Their demographic data were also collected by a separate questionnaire.

The frequency of schizophrenia disorder was higher in males aged ≥65 years. The comorbidity frequency of non-psychiatric disorders was significantly higher in the elderly, compared to non-elderly patients. The most prevalent comorbid disorders in the elderly were musculoskeletal, cardiovascular, and metabolic disorders; and in the non-elderly neurological, hematological, and digestive diseases. The prevalence of non-psychiatric medicine intake was significantly higher in the elderly. The prevalence of non-psychiatric medicine use in the elderly (e.g. aspirin, heart disease medications, hypertension medications, etc.) and non-elderly patients (e.g. anemia medications, antibiotics, anticonvulsants, etc.) was not similar. 

In schizophrenic patients, the old age period is associated with more comorbid disorders, compared to their healthy counterparts. Such comorbid profile is similar to other patients; e.g. the most prevalent comorbidities were musculoskeletal, cardiovascular, and metabolic disorders. Polypharmacy is a medical problem in the elderly, with numerous adverse effects. The adjunct consumption of psychiatric medications with the non-psychiatric ones highlights the vital phenomena of drug interactions and associated adverse effects of polypharmacy.

Due to aged population and the high prevalence of chronic psychiatric disorders in our country and necessity of collecting information for therapeutic and rehabilitation programming especially in hospitalized patients, this study was done to evaluate and study demographic characteristics of hospitalized chronic psychiatric patients over age 55 in the largest psychiatric hospital of the country in second half of 2002. This was a descriptive study that was done by studying of current data. Data were gathered using medical records and interview. Then the data were extracted and classified. All data were compared in male & female groups and difference between them was calculated by statistical tests. Of total number of 1025 hospitalized patients we evaluated 191 patients over age 55. There were 108 women and 83 men. The most common jobs of women and men were housewife and simple worker respectively. Many women were divorced and the men were unmarried. A large percent of both groups were illiterate and most common psychiatric diagnosis was schizophrenia in both groups. The disorder in two groups had gradual onset. Most patients were hospitalized more than 10 times and most of them did not have any visitors. Results indicate that these patients suffer from some psychological and somatic pains and they have poor social and family supporting. Thus we must try to program for de-institutionalization. More intention to rehabilitation and developing supporting systems are needed.