People with schizophrenia face a significantly higher risk of developing chronic obstructive pulmonary disease (COPD), according to a new study published in the July 2025 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation. This research suggests a possible syndemic relationship between the two diseases, compounded by inadequate medical care for individuals with schizophrenia.
COPD, a term that includes conditions such as emphysema and chronic bronchitis, is primarily caused by irritants like smoke, pollution, and genetic factors. An estimated 30 million Americans are affected by COPD, though only half are aware of their condition. The study highlights that individuals with schizophrenia are not only more likely to smoke tobacco, a known risk factor for COPD, but they also exhibit a higher prevalence of COPD even after accounting for smoking habits.
Understanding the Syndemic Relationship
The term “syndemic” refers to the interaction of two or more diseases that exacerbate the negative health effects of each other, often influenced by social, economic, and environmental factors. In the case of schizophrenia and COPD, shared risk factors such as socioeconomic status, environmental exposure, and genetic predispositions may contribute to the increased incidence of COPD among those with schizophrenia.
Moreover, individuals with schizophrenia often face barriers to receiving adequate medical care, leading to under-diagnosis and mismanagement of COPD. Symptoms of COPD can be mistakenly attributed to psychosomatic causes in these patients, further complicating their treatment.
The Role of Smoking and Medication
While smoking is a well-documented risk factor for COPD, the study emphasizes that the link between schizophrenia and COPD persists even after adjusting for smoking rates. This finding points to other contributing factors, including the potential impact of antipsychotic medications on respiratory health. Some medications have been linked to an increased risk of respiratory issues, including pneumonia.
“People with schizophrenia are less likely to use primary and preventative services or seek help for medical concerns. They also tend to prioritize mental health issues over physical illnesses,” said Professor David M.G. Halpin, MBBS, DPhil, FRCP, a professor of respiratory medicine at the University of Exeter. “We need to ensure primary care providers are aware that people with schizophrenia are at higher risk of developing COPD.”
Improving Care and Outcomes
Professor Halpin advocates for integrated care services that address both mental and physical health needs. Regular physical health checks and comprehensive care for patients with both schizophrenia and COPD could significantly improve outcomes and survival rates in this disadvantaged group.
Developing integrated care services and reducing stigma associated with mental illness are crucial steps towards better health outcomes. By ensuring that primary care providers recognize the heightened risk of COPD in patients with schizophrenia, healthcare systems can offer more tailored and effective interventions.
For those interested in further exploring the relationship between schizophrenia and COPD, the full study is available in the Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation. Access to current and past issues can be found at journal.copdfoundation.org.
