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Bidirectional relation between schizophrenia and epilepsy: A population‐based retrospective cohort study
Author(s) -
Chang YuTzu,
Chen PeiChun,
Tsai IJu,
Sung FungChang,
Chin ZhengNan,
Kuo HuangTsung,
Tsai ChangHai,
Chou IChing
Publication year - 2011
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2011.03268.x
Subject(s) - epilepsy , schizophrenia (object oriented programming) , cohort , hazard ratio , retrospective cohort study , incidence (geometry) , medicine , cohort study , population , psychiatry , confidence interval , pediatrics , psychology , environmental health , physics , optics
Summary Purpose: Schizophrenia and epilepsy may share a mutual susceptibility. This study examined the bidirectional relation between the two disorders. Methods: We used claims data obtained from the Taiwan National Health Insurance database to conduct retrospective cohort analyses. Analysis 1 compared 5,195 patients with incident schizophrenia diagnosed in 1999–2008 with 20,776 controls without the disease randomly selected during the same period, frequency matched with sex and age. Analysis 2 comprised a similar method to compare 11,527 patients with newly diagnosed epilepsy with 46,032 randomly selected sex‐ and age‐matched controls. At the end of 2008, analysis 1 measured the incidence and risk of developing epilepsy and analysis 2 measured the incidence and risk of developing schizophrenia. Key Findings: In analysis 1, the incidence of epilepsy was higher in the schizophrenia cohort than in the nonschizophrenia cohort (6.99 vs. 1.19 per 1,000 person‐years) with an adjusted hazard ratio (aHR) of 5.88 [95% confidence interval (CI) 4.71–7.36] for schizophrenia patients. In analysis 2, the incidence of schizophrenia was higher in the epilepsy cohort than in the nonepilepsy comparison cohort (3.53 vs. 0.46 per 1,000 person‐years) with an aHR of 7.65 (95% CI 6.04–9.69) for epilepsy patients. The effect of schizophrenia on subsequent epilepsy was greater for women, but the association between epilepsy and elevated incidence of schizophrenia was more pronounced in men. Significance: We found a strong bidirectional relation between schizophrenia and epilepsy. These two conditions may share common causes. Further studies on the mechanism are required.