Incidence patterns of cardiometabolic comorbidities in patients with schizophrenia: A retrospective cohort study in...

Schizophrenia is a chronic psychiatric disorder associated with functional decline, premature mortality, and substantial social burden. Beyond psychiatric symptoms, patients are highly susceptible to metabolic disorders such as hyperlipidemia, hypertension, and type 2 diabetes, which drive excess cardiovascular morbidity and mortality. This study aimed to quantify the incidence and temporal patterns of major cardiometabolic comorbidities following schizophrenia diagnosis using large-scale, population-based longitudinal data from Korea. Using the Korean Health Insurance Review and Assessment database, we constructed a nationwide retrospective cohort of 60,591 adults aged 20-65 years newly diagnosed with schizophrenia between 2012 and 2014. Individuals with preexisting hyperlipidemia, hypertension, or type 2 diabetes within one year of the index date were excluded. Participants were followed until incident cardiometabolic disorders or December 31, 2020. Age- and sex-specific incidence rates (IRs) and incidence rate ratios (IRRs) by baseline cardiometabolic status were estimated, and temporal sequences were examined among those with multiple events. Over up to 9 years of follow-up, the IRs per 1000 person-years were 28.1 for hyperlipidemia, 20.9 for hypertension, and 12.5 for diabetes in men, and 28.8, 16.6, and 11.3, respectively, in women. Incidence rates increased progressively with age. Preexisting cardiometabolic disease predicted subsequent events (IRRs: 2.5-3.2). During more than 5 years of follow-up, 25% of patients developed at least one cardiometabolic disorder and 9% developed two or more. Korean adults with schizophrenia face early and rapid accumulation of cardiometabolic complications, underscoring the need for timely detection and preventive intervention.