Self-reported health and smoking status, and body mass index: A case-control comparison based on GEN SCRIP (GENetics of SChizophRenia in Pakistan) data

Muhammad Ayub, Arsalan Arsalan, Shams Ud Din Ahmad Khan, Saqib Bajwa, Fahad Hussain, Muhammad Umar, Bakht Khizar, Muhammad Sibtain, Ayesha Butt, Mian Mukhtar-Ul-Haq, Imtiaz Ahmad Dogar, Moin Ahmad Ansari, Sadia Shafiq, Muhammad Tariq, Mian Iftikhar Hussain, Amina Nasar, Ali Burhan Mustafa, Rizwan Taj, Raza Ur Rehman, Atir Hanif RajputSyeda Ambreen, Syed Qalb E.Hyder Naqvi, Khalid Mehmood, Muhammad Younis Khan, Jawad Ali, Nasir Mehmood, Ammara Amir, Tanveer Nasr, Fazal Rabbani, Adil Afridi, Zahid Nazar, Muhammad Idrees, Ahsan Ul Haq Chishti, Rana Muzammil Shamsher Khan, Anisuzzaman Khan, Rubina Aslam, Muntazir Mehdi, Aftab Asif, Ali Zulqarnain, Jalil Afridi, Asif Hussain, Sibtain Anwar, Saad Salman, Inzemam Khan, Zia Ul Mabood, Hamzalah Hamzalah, Adan Javed, Komal Nawaz, Kainat Zahra, Urooj Nayyar, Syeda Tooba, Ammara Ali Rajput, Anum Anjum, Ayesha Rehman, Maria Kanwal, Tahira Yasmeen, Sadia Hassan, Mariyam Ali Zaidi, Dur E. Nayab, Muhammad Kamal, Bisma Jamil, Rida Malik, Ihtisham Ul Haq, Zohra Bibi, Kalsoom Nawaz, Munaza Anwer, Afzal Javed, Nusrat Habib Rana, Muhammad Nasar Sayeed Khan, Farooq Naeem, Carlos N. Pato, Michele T. Pato, Saeed Farooq, James A. Knowles

Research output: Contribution to journalArticlepeer-review


Introduction Individuals with schizophrenia are at a high risk of physical health comorbidities and premature mortality. Cardiovascular and metabolic causes are an important contributor. There are gaps in monitoring, documenting and managing these physical health comorbidities. Because of their condition, patients themselves may not be aware of these comorbidities and may not be able to follow a lifestyle that prevents and manages the complications. In many low-income and middle-income countries including Pakistan, the bulk of the burden of care for those struggling with schizophrenia falls on the families. Objectives To determine the rate of self-reported physical health disorders and risk factors, like body mass index (BMI) and smoking, associated with cardiovascular and metabolic disorders in cases of schizophrenia compared with a group of mentally healthy controls. Design A case-controlled, cross-sectional multicentre study of patients with schizophrenia in Pakistan. Settings Multiple data collection sites across the country for patients, that is, public and private psychiatric OPDs (out patient departments), specialised psychiatric care facilities, and psychiatric wards of teaching and district level hospitals. Healthy controls were enrolled from the community. Participants We report a total of 6838 participants' data with (N 3411 (49.9%)) cases of schizophrenia compared with a group of healthy controls (N 3427 (50.1%)). Results BMI (OR 0.98 (CI 0.97 to 0.99), p=0.0025), and the rate of smoking is higher in patients with schizophrenia than in controls. Problems with vision (OR 0.13 (0.08 to 0.2), joint pain (OR 0.18 (0.07 to 0.44)) and high cholesterol (OR 0.13 (0.05 to 0.35)) have higher reported prevalence in controls. The cases describe more physical health disorders in the category â € other' (OR 4.65 (3.01 to 7.18)). This captures residual disorders not listed in the questionnaire. Conclusions Participants with schizophrenia in comparison with controls report more disorders. The access in the â € other' category may be a reflection of undiagnosed disorders.

Original languageEnglish
Article numbere042331
JournalBMJ Open
Issue number4
Publication statusPublished - 8 Apr 2021
Externally publishedYes


  • mental health
  • public health
  • schizophrenia & psychotic disorders


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