Can we prolong the lives of patients suffering from schizophrenia with currently available treatment options?
Authors:
Eva Kitzlerová; Marek Kupka; Monika Nováková
Authors‘ workplace:
Psychiatrická klinika 1. LF UK a VFN v Praze
Published in:
Čes. a slov. Psychiat., 122, 2026, No. 5, pp. 172-182.
Category:
Review
doi:
https://doi.org/10.48095/cccsp202612
Overview
Patients suffering from severe mental illnesses, particularly schizophrenia, are at increased risk of developing mental and physical comorbidities, including other complications that lead to a reduced quality of life, increased need for health care, and premature death. Early detection, diagnosis, and prompt initiation of appropriate treatment for recognized mental illness are absolutely essential. Current evidence clearly demonstrates the positive effect of long-term antipsychotic treatment on reducing mortality among patients with schizophrenia, despite its known adverse effects. A strictly individualized selection of psychopharmacological treatment is necessary, with a preference for modern, cardiometabolically safe psychotropic medications in their most advanced available forms (long-acting injectable antipsychotics – LAIs) preferrably in the early stages of the illness. Comprehensive treatment of mental illness in the 21st century should include early incorporation of educational programs focused on a healthy lifestyle, obesity prevention, smoking cessation, and abstinence from psychoactive substances, as well as interventions aimed at suicide prevention, particularly screening for suicidal risks especially in the initial stages of the illness. A combination of dietary modifications and physical activity, when provided preventively, has a demonstrable effect in patients suffering from psychosis, leading to the minimization of weight gain and prevention of developing subsequent cardiometabolic complications. Education on nutritional recommendations (ideally with specific nutritional counseling focused on optimizing gut dysbiosis and suppressing immune changes associated with the production of inflammatory cytokines), particularly during the first 3 months after starting psychopharmacological medication, has a positive effect on preventing weight gain, reducing body mass index, improving quality of life, and enhancing body image. Prevention and comprehensive treatment of schizophrenia should include promoting cardiorespiratory fitness and increasing aerobic physical activity, which has been shown to reduce the incidence of the disease, improve its course, positively impact cognitive function, and enhance the patients’ quality of life. To provide high-quality, comprehensive care to patients suffering from mental illness, particularly schizophrenia, interdisciplinary collaboration with well--informed specialists and primary care physicians is essential, as is the implementation of recommended practices in the care of somatic health for patients with severe mental illness by both psychiatrists and somatic physicians. If such a comprehensive approach becomes a routine part of the treatment of our patients, we can also positively influence their mortality.
Keywords:
prevention – Schizophrenia – cardiovascular disease – lifestyle – premature mortality – atypical long-acting injectable antipsychotics (LAIs)
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Addictology Paediatric psychiatry PsychiatryArticle was published in
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2026 Issue 5
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