It is a well known fact that mentally ill patients, especially those with schizophrenia, have a higher incidence of somatic diseases than the general population and finally a significantly shorter life expectancy. In this paper a comparison is made between schizophrenia and somatic comorbidity before the era of antipsychotics and after, with consideration to the prevalent morbidity during each of these periods. In the period before antipsychotics acute infectious diseases and TBC were the prevalent comorbid diseases. High comorbidity rates were due not only to epidemics but also poor treatment success, deficient health habits and poor personal hygiene. In the period after the discovery of antipsychotics significant changes in morbidity occurred with the prevalence of chronic degenerative diseases, primarily diabetes, hypertension and dyslipidemia. Studies show that new generation antipsychotics partly generate the occurrence of metabolic disorders, which makes it necessary to consider the choice of antipsychotic depending on the assessed risk in every individual case
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