English Polski
Vol 19, No 2 (2022)
Case report
Published online: 2021-12-23
Page views 3972
Article views/downloads 47
Get Citation

Connect on Social Media

Connect on Social Media

A sound mind in a sound body- how crucial is a cooperation between medical specialists and patients with coexisting mental and somatic disorders?

Klaudia Adamczewska-Chmiel1, Martyna Bień1, Katarzyna Dudzic1, Krzysztof Krysta2, Marek Krzystanek2
Psychiatria 2022;19(2):123-127.


In the treatment of patients with mental disorders, the management of coexisting somatic disorders poses

additional difficulties. In the article, a case report of a 65-year-old male diagnosed with schizophrenia,

as well as with cardiac arrhythmia was presented. Additionally, the patient has been addicted to alcohol

since the age of 18 and manifests signs of metabolic syndrome. Due to a syncope, he was admitted to

the cardiology department, where the diagnose of arrhythmias in the form of atrial fibrillation was made.

During periods of exacerbation of mental illness, the patient tends to discontinue the use of both psychiatric

and recommended somatic diseases drugs. Due to the patient’s persistent atrial fibrillation, the

sudden withdrawal of cardiac medications significantly increases the risk of somatic complications including

stroke. Effective management of both mental and somatic disorders is crucial, which requires close

multidisciplinary cooperation between a psychiatrist and cardiologist as well as the patient and his family.

Article available in PDF format

Add to basket: 49.00 PLN

Aready have access?


  1. Penninx B.W.J.H., Lange S.M.M. Metabolic syndrome in psychiatric patients: Overview, mechanisms, and implications. Dialogues Clin Neurosci. 2018; 20: 63S–73S.
  2. Penninx BW, Milaneschi Y, Lamers F, et al. Understanding the somatic consequences of depression: biological mechanisms and the role of depression symptom profile. BMC Med. 2013; 11: 129.
  3. Mitchell AJ, Vancampfort D, Sweers K, et al. Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders--a systematic review and meta-analysis. Schizophr Bull. 2013; 39(2): 306–318.
  4. McIntyre RS, Soczynska JK, Beyer JL, et al. Medical comorbidity in bipolar disorder: re-prioritizing unmet needs. Curr Opin Psychiatry. 2007; 20(4): 406–416.
  5. Batelaan NM, Seldenrijk A, Bot M, et al. Anxiety and new onset of cardiovascular disease: critical review and meta-analysis. Br J Psychiatry. 2016; 208(3): 223–231.
  6. Kritharides L, Chow V, Lambert TJr. Cardiovascular disease in patients with schizophrenia. Med J Aust. 2017; 206(2): 91–95.
  7. Vos T., Barber R.M., Bell B. i wsp. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015; 386: 743S–800S.
  8. Laursen TM, Munk-Olsen T, Vestergaard M, et al. Chronic somatic comorbidity and excess mortality due to natural causes in persons with schizophrenia or bipolar affective disorder. PLoS One. 2011; 6(9): e24597–88.
  9. Wulff K, Dijk DJ, Middleton B, et al. Sleep and circadian rhythm disruption in schizophrenia. Br J Psychiatry. 2012; 200(4): 308–316.
  10. Olfson M, Gerhard T, Huang C, et al. Premature Mortality Among Adults With Schizophrenia in the United States. JAMA Psychiatry. 2015; 72(12): 1172–1181.
  11. Goff DC, Sullivan LM, McEvoy JP, et al. A comparison of ten-year cardiac risk estimates in schizophrenia patients from the CATIE study and matched controls. Schizophr Res. 2005; 80(1): 45–53.
  12. Gale CR, Batty GD, Osborn DPJ, et al. Mental disorders across the adult life course and future coronary heart disease: evidence for general susceptibility. Circulation. 2014; 129(2): 186–193.
  13. Hennekens CH, Hennekens AR, Hollar D, et al. Schizophrenia and increased risks of cardiovascular disease. Am Heart J. 2005; 150(6): 1115–1121.
  14. Ruschena D, Mullen P, Burgess P, et al. Sudden death in psychiatric patients. British Journal of Psychiatry. 2018; 172(4): 331–336.
  15. Robillard R, Rogers NL, Whitwell BG, et al. Are cardiometabolic and endocrine abnormalities linked to sleep difficulties in schizophrenia? A hypothesis driven review. Clin Psychopharmacol Neurosci. 2012; 10(1): 1–12.
  16. Vancampfort D, Stubbs B, Mitchell AJ, et al. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis. World Psychiatry. 2015; 14(3): 339–347.
  17. Baykara S, Yılmaz M, Baykara M. QT dispersion and P wave dispersion in schizophrenia. Psychiatry and Clinical Psychopharmacology. 2018; 29(4): 538–543.
  18. Andreassen OA, Djurovic S, Thompson WK, et al. International Consortium for Blood Pressure GWAS, Diabetes Genetics Replication and Meta-analysis Consortium, Psychiatric Genomics Consortium Schizophrenia Working Group. Improved detection of common variants associated with schizophrenia by leveraging pleiotropy with cardiovascular-disease risk factors. Am J Hum Genet. 2013; 92(2): 197–209.
  19. Voskoboinik A, Kalman JM, De Silva A, et al. Alcohol Abstinence in Drinkers with Atrial Fibrillation. N Engl J Med. 2020; 382(1): 20–28.
  20. Chou RH, Lo LW, Liou YJ, et al. Antipsychotic treatment is associated with risk of atrial fibrillation: A nationwide nested case-control study. Int J Cardiol. 2017; 227: 134–140.
  21. Rojo LE, Gaspar PA, Silva H, et al. Metabolic syndrome and obesity among users of second generation antipsychotics: A global challenge for modern psychopharmacology. Pharmacol Res. 2015; 101: 74–85.
  22. Ijaz S, Bolea B, Davies S, et al. Antipsychotic polypharmacy and metabolic syndrome in schizophrenia: a review of systematic reviews. BMC Psychiatry. 2018; 18(1): 275.
  23. Siwek M, Woroń J, Gorostowicz A, et al. Adverse effects of interactions between antidepressants and medications used in treatment of cardiovascular disorders. Psychiatr Pol. 2019; 53(5): 977–995.
  24. Munro I, Edward KL. Mental illness and substance use: an Australian perspective. Int J Ment Health Nurs. 2008; 17(4): 255–260.