Schizophrenia: no health without physical health.

1Department of General Psychiatry 1, Institute of Mental Health, Singapore 2Offi ce of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore 3Schizophrenia Division, Centre for Addiction and Mental Health, Canada 4Neuroscience & Behavioral Disorders, Duke-NUS Graduate Medical School, Singapore 5Department of Psychiatry, University of Toronto, Canada Address for Correspondence: Dr Jimmy Lee, Department of General Psychiatry, Institute of Mental Health, 10 Buangkok View, Singapore 539747. Email: [email protected] Introduction Schizophrenia is a severe and chronic mental disorder, with onset routinely occurring in late adolescence. It is associated with the poorest outcomes among all described psychotic conditions, and there is currently no cure. However, effective treatments are available to mitigate some of the psychiatric symptoms, and more recent studies have suggested that outcome in schizophrenia may not be as pessimistic as once thought. For example, we now know from longer-term follow-up studies that about one-third of individuals with schizophrenia can achieve recovery at some point over a 10-year interval.1 It remains, though, that schizophrenia is for many a debilitating illness. The recently completed Global Burden of Disease Study (2010) ranked schizophrenia as one of the 5 leading causes of disability among all mental and substance use disorders. Notably, schizophrenia appeared to make a larger contribution to years lived with disability (YLD) than years of life lost (YLL) because mental disorders are rarely fatal. However, what is not considered in the computation of burden is the increased risk of physical illnesses and consequent reduced life expectancy frequently observed in individuals with schizophrenia. The unfortunate reality is that individuals with schizophrenia are at greater risk for medical illnesses and chronic medical conditions.2 All these exact signifi cant burden with a consequent impact on morbidity and mortality.