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    Schizophrenia Linked to Early Death

    Suicide, Cancer, Heart Disease Leading Causes of Death in Schizophrenics

    Schizophrenia Treatment and Breast Cancer

    Although the excess in breast cancer deaths could be explained by delayed diagnosis and poorer access to or compliance with treatment, schizophrenia expert Donald C. Goff, MD, says there may be more going on.

    Goff cites a 2002 study, which suggested a link between the use of dopamine-blocking drugs, including the antipsychotics used to treat schizophrenia, and an increased risk for breast cancer.

    "This study raised questions about whether antipsychotics cause breast cancer," Goff tells WebMD. "The conclusion at the time was that there wasn't much evidence to support this."

    Goff, who directs the schizophrenia program at Massachusetts General Hospital, says it has long been recognized that patients with schizophrenia are at risk for early death, but efforts to address this have generally targeted suicide prevention, smoking cessation, and heart disease.

    Gregory Dalack, MD, tells WebMD that the psychiatric community is increasingly recognizing the need to integrate primary care interventions into psychiatric practice.

    Dalack is interim chair of the department of psychiatry at the University of Michigan Health System.

    "These patients are vulnerable," he says. "They are high risk, and yet we are not doing the basic things for them that we do for other high-risk populations."

    Because so many mentally ill patients do not have primary care doctors, psychiatrists are increasingly doing things like weighing patients, taking waist circumference measurements, and discussing smoking cessation and exercise, he says.

    "But it is hard to talk about exercise with a patient who is worried about paying the rent or putting food on the table," he says, adding that a focus of health care reform should be better integration of primary and mental health care.

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