A large body of evidence has demonstrated that schizophrenic individuals are afflicted with a wide array of medical problems. Some of these issues are likely due to genetic abnormalities that are associated with schizophrenia. Other medical concerns develop as a result of poor attention to self-care and inconsistent medical follow-up that arise from the hypofrontality/negative symptoms that actually generate most of the longitudinal morbidity of schizophrenia. Schizophrenic patients are also more likely to engage in lifestyle behaviors that affect their health status adversely, such as poor compliance with medications and/or perioperative instructions, smoking, poor dietary intake, and use of drugs and alcohol. It is also likely that antipsychotic medications contribute to this greater prevalence of medical co-morbidities. Taken together, these medical issues significantly increase operative risk in schizophrenic patients.

It has been estimated that schizophrenic patients have a 20% shorter life expectancy than age-matched controls. Another study found that schizophrenia is associated with a greater prevalence of heart disease, chronic obstructive pulmonary disease, hypertension, and diabetes. Some research suggests that there are increased rates of hyperglycemia and diabetes, hyperlipidemia, hypercholesterolemia, and obesity that occur as intrinsic, associated features of this illness. Obstructive sleep apnea is especially prevalent among schizophrenic patients. The operative risks posed by these problems are only exacerbated by the tendency for schizophrenic patients to neglect their own care. These metabolic abnormalities are allowed to persist without medical intervention far more frequently than is the case in the general population. Thus, progression to significant cardiac, pulmonary, and renal pathology is more frequent, leading to greater operative risk.