Managing health in dual diagnosis: narratives from individuals with schizophrenia and diabetes

 

Frontiers in Psychiatry

 

DOI:10.3389/fpsyt.2025.1713082

License
CC BY 4.0

Authors:

Matilde Zerne Nilsson

University of Gothenburg
Carina Sparud-Lundin

University of Gothenburg
Katarina Eeg-Olofsson

Peter Sand

University of Gothenburg
 

ABSTRACT

Introduction

Schizophrenia, often accompanied by cognitive impairments, increases the risk of diabetes, complicating self-care and overall health management. Exploring the lived experiences of individuals who face both mental and physical illness—and, in many cases, pronounced cognitive or functional challenges—is critical for developing more effective and integrated care strategies. Aim This study examined the daily lives of individuals living with schizophrenia and diabetes, focusing on their health-related experiences and interactions with healthcare services.

 

Methods

Twenty-two participants diagnosed with schizophrenia and type 1 or type 2 diabetes, including individuals with significant cognitive and functional impairments, were interviewed in a qualitative study. Data were analyzed using thematic analysis grounded in descriptive phenomenology.

 

Results

Three themes captured participants’ experiences:

(1) Perceptions of health shaped by personal narratives, including the role of insight, autonomy, and meaning;

(2) Struggles with navigating health in daily life, as participants balanced medication effects, symptoms, and practical constraints while attempting recommended routines; and

(3) Need for formal support in managing health, with valued help often being concrete, everyday assistance alongside respectful, encouraging relationships with providers.

 

Conclusion

These findings highlight the importance of holistic, coordinated care that integrates mental and physical health, addresses practical barriers, and fosters self-understanding. By including participants with cognitive impairments, this study adds new insight into how such challenges influence daily health management and the types of support needed to sustain engagement in care.

 

 

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5. Conclusion

 

Our findings highlight the unique health experiences of individuals living with both schizophrenia and diabetes, particularly those with additional cognitive impairments. Although participants understood the importance of preventive lifestyle behaviors, they often struggled to integrate and sustain them in daily life. Interventions that help individuals make sense of their illness history and foster a coherent sense of identity are crucial, as such subjective understanding influences health behaviors, treatment adherence, and meaningful lifestyle change.

 

From a clinical perspective, these results underscore the importance of coordinated care that addresses both cognitive impairments, physical health management and ensures comprehensive care that enhances treatment adherence and self-care. Healthcare providers play a key role in tailoring support to each patient’s lived experience, combining practical assistance with recognition of subjective well-being. Identifying personal resources, addressing barriers such as stigma and financial constraints, and providing integrated multidisciplinary care can improve outcomes and quality of life for this population.

 

Ultimately, systemic accountability is needed to ensure that people with dual diagnoses receive comprehensive, holistic care that bridges psychiatric and somatic health.

 

 

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