Newswise — Heart disease is the leading cause of death in the United States, and it's about twice as deadly for people with schizophrenia. The November 2007 issue of the Harvard Mental Health Letter looks at why the risk is so great for people with schizophrenia and what can they do to reduce it.

People with schizophrenia are more likely than other Americans to have one or more of the major risk factors for heart disease. They are also less likely to receive good preventive care, in large part because they are more likely to see a psychiatrist than a primary care physician or cardiologist. This puts more of a burden for assessing and monitoring heart health on the mental health team—or on patients and families.

Another important factor that can impede preventive care is medication noncompliance. Research indicates that at least half of people with schizophrenia will stop taking their antipsychotic medication at some point, so clinicians may assume that compliance with other medications will also be poor.

The Harvard Mental Health Letter suggests the following ways people with schizophrenia can lower their heart risk, with help from clinicians and loved ones:

Control the food environment. Advocate for healthier choices in institutional settings (such as group homes and day treatment programs), and keep healthier foods at home.

Beware of liquid calories. Consider a low-calorie alternative to soda, preferably water.

Don't "kill with kindness." Family members and clinicians should not turn a blind eye when people with schizophrenia adopt detrimental health habits—such as smoking or indulging in high-calorie foods—simply because these patients face other difficult challenges.

Also in this issue:"¢ Early signs of autism"¢ Perils of perfectionism"¢ The high cost of children's mental health care"¢ Age-related macular degeneration and depression"¢ Writer's cramp"¢ Nocturnal binge eating

The Harvard Mental Health Letter is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $59 per year. Subscribe at http://www.health.harvard.edu/mental or by calling 1-877-649-9457 (toll free).