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Older veterans with schizophrenia often have multiple chronic conditions, or multimorbidity, yet most prior research has focused on single medical conditions. A study presented at the American Psychiatric Association (APA) annual meeting characterized multimorbidity patterns and healthcare utilization among older veterans with schizophrenia to understand how multimorbidity affects this population and their clinical service needs.

In this exclusive 番茄社区 video, , a psychiatry fellow at the University of California San Francisco Weill Institute for Neurosciences, describes findings.

Following is a transcript of her remarks:

This work really comes out of an interest in looking at aging in schizophrenia. And we know that older adults, older veterans with schizophrenia, often have multiple chronic medical conditions, which is also called multimorbidity. But most studies have focused on a single condition. And so we were interested in looking at profiles or patterns of multimorbidity in the population and also how that relates to healthcare services utilization as well as mortality.

What we did is we looked at a cohort of veterans ages 50 years and older, followed them across several years from 2012 to 2019. And then we applied a method called latent class analysis that can identify different subgroups in a population based on common characteristics or traits. And we applied that analysis across 20 different comorbid medical neuropsychiatric conditions that are particularly relevant to aging adults with serious mental illness and schizophrenia in particular.

And we identified three distinct classes. And we called the classes low comorbidity, high comorbidity, and substance use disorders and related conditions. The low or minimal comorbidity group made up 67% of our cohort, the high comorbidity group made up 17.6% of our cohort, and the substance use disorders and related conditions group made up 15.4% of the cohort.

And I think what was interesting here is the minimal comorbidity class had a lower than 10% prevalence of all of these major comorbid diagnoses. So across cardiovascular disease, respiratory disease, mental health conditions, and substance use conditions -- other than tobacco use, that was the one exception -- the high comorbidity class had greater than 20% prevalence of congestive heart failure, COPD [chronic obstructive pulmonary disease], dementia, renal disease, sleep disorders, and depression.

And then the substance use disorders and related conditions group had a greater than 70% prevalence of alcohol and drug use disorders, and a greater than 20% prevalence of what we thought of as related disorders -- COPD, hepatitis C, depression, and PTSD [post-traumatic stress disorder].

And although the high comorbidity class had the highest rates of chronic medical conditions, the substance use disorders and related conditions class had the highest rates of emergency and inpatient medical care and emergency inpatient and outpatient mental healthcare utilization.

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