Asthma, corticosteroid use and schizophrenia: A nationwide populationbased study in Taiwan

Wei Chen Wang, Mong Liang Lu, Vincent Chin Hung Chen, Mei Hing Ng, Kuo You Huang, Ming Hong Hsieh, Meng Jer Hsieh, Roger S. Mcintyre, Yena Lee, Charles Tzu Chi Lee

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective Asthma and corticosteroid use have been implicated as possible risk factors for schizophrenia. The retrospective cohort study herein aimed to investigate the association between asthma, corticosteroid use, and schizophrenia. Method Longitudinal data (2000 to 2007) from adults with asthma (n = 50,046) and without asthma (n = 50,046) were compared on measures of schizophrenia incidence using Taiwan's National Health Insurance Research Database (NHIRD). Incidence of schizophrenia diagnosis (ICD-9 codes 295.XX) between 2000 and 2007 were compared between groups. Competing risk-adjusted Cox regression analyses were conducted, adjusting for sex, age, residence, socioeconomic status, corticosteroid use, outpatient and emergency room visit frequency, Charlson comorbidity index, and total length of hospital stays days for any disorder. Results Of the 75,069 subjects, 238 received a diagnosis of schizophrenia. The mean (SD) followup interval for all subjects was 5.8 (2.3) years. After adjusting for potential confounding factors, asthma was associated with significantly greater hazard ratio for incident schizophrenia 1.40 (95% CI = 1.05, 1.87). Additional factors associated with greater incidence of schizophrenia were rural residence, lower economic status, and poor general health. Older age (i.e. 65 years) was negatively associated with schizophrenia incidence. Corticosteroid use was not associated with increased risk for schizophrenia. Conclusions Asthma was associated with increased risk for schizophrenia. The results herein suggest that a convergent disturbance in the immune-inflammatory system may contribute to the pathoetiology of asthma and schizophrenia.

Original languageEnglish
Article numbere0173063
JournalPLoS One
Volume12
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

Fingerprint

national surveys
asthma
adrenal cortex hormones
Taiwan
Schizophrenia
Adrenal Cortex Hormones
Asthma
Emergency rooms
Health insurance
Immune system
incidence
Hazards
Incidence
International Classification of Diseases
socioeconomic status
Health
Length of Stay
Economics
schizophrenia
health insurance

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Wang, W. C., Lu, M. L., Chen, V. C. H., Ng, M. H., Huang, K. Y., Hsieh, M. H., ... Lee, C. T. C. (2017). Asthma, corticosteroid use and schizophrenia: A nationwide populationbased study in Taiwan. PLoS One, 12(3), [e0173063]. https://doi.org/10.1371/journal.pone.0173063

Asthma, corticosteroid use and schizophrenia : A nationwide populationbased study in Taiwan. / Wang, Wei Chen; Lu, Mong Liang; Chen, Vincent Chin Hung; Ng, Mei Hing; Huang, Kuo You; Hsieh, Ming Hong; Hsieh, Meng Jer; Mcintyre, Roger S.; Lee, Yena; Lee, Charles Tzu Chi.

In: PLoS One, Vol. 12, No. 3, e0173063, 01.03.2017.

Research output: Contribution to journalArticle

Wang, WC, Lu, ML, Chen, VCH, Ng, MH, Huang, KY, Hsieh, MH, Hsieh, MJ, Mcintyre, RS, Lee, Y & Lee, CTC 2017, 'Asthma, corticosteroid use and schizophrenia: A nationwide populationbased study in Taiwan', PLoS One, vol. 12, no. 3, e0173063. https://doi.org/10.1371/journal.pone.0173063
Wang, Wei Chen ; Lu, Mong Liang ; Chen, Vincent Chin Hung ; Ng, Mei Hing ; Huang, Kuo You ; Hsieh, Ming Hong ; Hsieh, Meng Jer ; Mcintyre, Roger S. ; Lee, Yena ; Lee, Charles Tzu Chi. / Asthma, corticosteroid use and schizophrenia : A nationwide populationbased study in Taiwan. In: PLoS One. 2017 ; Vol. 12, No. 3.
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AB - Objective Asthma and corticosteroid use have been implicated as possible risk factors for schizophrenia. The retrospective cohort study herein aimed to investigate the association between asthma, corticosteroid use, and schizophrenia. Method Longitudinal data (2000 to 2007) from adults with asthma (n = 50,046) and without asthma (n = 50,046) were compared on measures of schizophrenia incidence using Taiwan's National Health Insurance Research Database (NHIRD). Incidence of schizophrenia diagnosis (ICD-9 codes 295.XX) between 2000 and 2007 were compared between groups. Competing risk-adjusted Cox regression analyses were conducted, adjusting for sex, age, residence, socioeconomic status, corticosteroid use, outpatient and emergency room visit frequency, Charlson comorbidity index, and total length of hospital stays days for any disorder. Results Of the 75,069 subjects, 238 received a diagnosis of schizophrenia. The mean (SD) followup interval for all subjects was 5.8 (2.3) years. After adjusting for potential confounding factors, asthma was associated with significantly greater hazard ratio for incident schizophrenia 1.40 (95% CI = 1.05, 1.87). Additional factors associated with greater incidence of schizophrenia were rural residence, lower economic status, and poor general health. Older age (i.e. 65 years) was negatively associated with schizophrenia incidence. Corticosteroid use was not associated with increased risk for schizophrenia. Conclusions Asthma was associated with increased risk for schizophrenia. The results herein suggest that a convergent disturbance in the immune-inflammatory system may contribute to the pathoetiology of asthma and schizophrenia.

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