Treatment of ischaemic heart disease and stroke in individuals with psychosis under universal healthcare
Open accessAbstract
Background: Most data on the quality of vascular care for individuals with psychiatric conditions come from countries without universal healthcare. Aims: To investigate the treatment of people with psychosis admitted for ischaemic heart disease or stroke under universal healthcare. Method: A population-based study of administrative data comparing Canadians with and without a history of schizophrenia or related psychosis (n= 65 039). Results: Of 49 248 admissions for ischaemic heart disease, 1285 had a history of psychosis. Despite a higher 1-year mortality, they were less likely to receive guideline-consistent treatment: e.g. coronary artery bypass grafting (adjusted odds ratio (OR) = 0.35, 95% CI 0.25–0.48), beta-blockers (adjusted OR = 0.82, 95% CI 0.71–0.95) and statins (adjusted OR = 0.51, 95% CI 0.41–0.63). Of 15 791 admissions for stroke, 594 had a history of psychosis. Despite higher 1-year mortality rates, they were less likely to receive cerebrovascular arteriography or warfarin. Conclusions: People with a history of psychosis do not receive equitable levels of vascular care under universal healthcare.
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Patients with psychiatric disorders receive less treatment for physical conditions than do people without psychiatric disorders.
“This interpretation is supported by studies documenting that patients with psychiatric disorders receive less treatment for physical conditions than do people without psychiatric disorders (Kisely et al. 2009, Laursen et al. 2009, Lawrence et al. 2000).”
From Excess early mortality in schizophrenia. (2014) · cites this paper as Kisely et al. 2009
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- Authors
- Kisely, S., Campbell, L. A., & Wang, Y.
- Affiliations
- Capital District Health Authority (CA)
- Dalhousie University (CA)
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2009-12
- Volume
- 195
- Issue
- 6
- Pages
- 545-550
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2073952198
- Cited by
- 116
- References
- 4
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 7 · 2023: 6 · 2022: 7 · 2021: 5 · 2020: 3 · 2019: 8 · 2018: 10 · 2017: 6 · 2016: 10 · 2015: 7 · 2014: 6 · 2013: 9 · 2012: 12
- FWCI
- 5.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion)
- Funders
- Heart and Stroke Foundation of Canada
- Dalhousie University
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- psychosis, schizophrenia, ischemic heart disease, stroke, vascular care, coronary artery bypass grafting, beta-blockers, statins, warfarin, health equity, universal health care, mortality, Canada
- MeSH terms
- Aged, Aged, 80 and over, Delivery of Health Care, Female, Humans, Male, Nova Scotia, Quality of Health Care, Retrospective Studies, Schizophrenia, Socioeconomic Factors, Logistic Models, Myocardial Ischemia, Universal Health Insurance, Stroke
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