The management of psychotic symptoms is critical to schizophrenia treatment. However, monitoring patients' physical health, in particular how this impacts life expectancy, quality of life and compliance, should be considered because of its significant influence on short and long term health outcomes.

Between June and October 2006, 54,618 European psychiatrists in 12 countries received a survey containing 10 questions addressing physical health. Responders rated areas of concern, physical health monitoring and impact of antipsychotic therapy.

Among the first 3,764 psychiatrists, 84% consider physical health very important, with weight as the major concern for 63%. The top concerns in terms of impact of physical health are compliance (41%) followed by increased mortality risk (38%). While 88% say they undertake physical examination, only half do so on a regular basis. The most problematic side effects of antipsychotic treatments are weight gain (56%), metabolic impact (29%), extrapyramidal symptoms (21%) and sedation (7%), but only 1% report insomnia as an issue. When considering treatment related weight gain, 85% provide diet and lifestyle education with 55% monitoring weight, however, 66% of this intervention is unsuccessful.

The results show a substantial interest and awareness in the management of physical health in schizophrenia. Psychiatrists are monitoring to a certain extent but management strategies are often unsuccessful. Effective physical health programs in schizophrenia, including close monitoring and weight management, have yet to be optimized across Europe.