Self-reported health and smoking status, and body mass index: a case-control comparison based on GEN SCRIP (GENetics of SChizophRenia In Pakistan) data
Authors: Ayub Muhammad , Arsalan Arsalan , Khan Shams-ud-Din Ahmad , Bajwa Saqib , Hussain Fahad , Umar Muhammad , Khizar Bakht , Sibtain Muhammad , Butt Ayesha , Mukhtar-Ul-Haq Mian , Dogar Imtiaz Ahmad , Ansari Moin Ahmad , Shafiq Sadia , Tariq Muhammad , Hussain Mian Iftikhar , Nasar Amina , Mustafa Ali Burhan , Taj Rizwan , Rehman Raza Ur , Rajput Atir Hanif , Ambreen Syeda , Naqvi Syed Qalb-e-Hyder , Mehmood Khalid , Khan Muhammad Younis , Ali Jawad , Mehmood Nasir , Amir Ammara , Nasr Tanveer , Rabbani Fazal , Afridi Adil , Nazar Zahid , Idrees Muhammad , Chishti Ahsan ul Haq , Shamsher Khan Rana Muzammil , Khan Anisuzzaman , Aslam Rubina , Mehdi Muntazir , Asif Aftab , Zulqarnain Ali , Afridi Jalil , Hussain Asif , Anwar Sibtain , Salman Saad , Khan Inzemam , Mabood Zia ul , Hamzalah Hamzalah , Javed Adan , Nawaz Komal , Zahra Kainat , Nayyar Urooj , Tooba Syeda , Rajput Ammara Ali , Anjum Anum , Rehman Ayesha , Kanwal Maria , Yasmeen Tahira , Hassan Sadia , Zaidi Mariyam Ali , Nayab Dur E , Kamal Muhammad , Jamil Bisma , Malik Rida , Ul Haq Ihtisham , Bibi Zohra , Nawaz Kalsoom , Anwer Munaza , Javed Afzal , Rana Nusrat Habib , Khan Muhammad Nasar Sayeed , Naeem Farooq , Pato Carlos N , Pato Michele T , Farooq Saeed , Knowles James A 
Published: April 2021

IntroductionIndividuals with schizophrenia are at a high risk of physical health comorbidities and premature mortality. Cardiovascular and metabolic causes are an important contributor. There are gaps in monitoring, documenting and managing these physical health comorbidities. Because of their condition, patients themselves may not be aware of these comorbidities and may not be able to follow a lifestyle that prevents and manages the complications. In many low-income and middle-income countries including Pakistan, the bulk of the burden of care for those struggling with schizophrenia falls on the families.ObjectivesTo determine the rate of self-reported physical health disorders and risk factors, like body mass index (BMI) and smoking, associated with cardiovascular and metabolic disorders in cases of schizophrenia compared with a group of mentally healthy controls.DesignA case-controlled, cross-sectional multicentre study of patients with schizophrenia in Pakistan.SettingsMultiple data collection sites across the country for patients, that is, public and private psychiatric OPDs (out patient departments), specialised psychiatric care facilities, and psychiatric wards of teaching and district level hospitals. Healthy controls were enrolled from the community.ParticipantsWe report a total of 6838 participants’ data with (N 3411 (49.9%)) cases of schizophrenia compared with a group of healthy controls (N 3427 (50.1%)).ResultsBMI (OR 0.98 (CI 0.97 to 0.99), p=0.0025), and the rate of smoking is higher in patients with schizophrenia than in controls. Problems with vision (OR 0.13 (0.08 to 0.2), joint pain (OR 0.18 (0.07 to 0.44)) and high cholesterol (OR 0.13 (0.05 to 0.35)) have higher reported prevalence in controls. The cases describe more physical health disorders in the category ‘other’ (OR 4.65 (3.01 to 7.18)). This captures residual disorders not listed in the questionnaire.ConclusionsParticipants with schizophrenia in comparison with controls report more disorders. The access in the ‘other’ category may be a reflection of undiagnosed disorders.