Prevalence of schizophrenia in patients with psoriasis: a nationwide study

Hung Pin Tu, Chu Ling Yu, Cheng Che E Lan, Sebastian Yu

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background/Objective The prevalence of selected psychiatric disorders, such as depression and anxiety, is higher in patients with psoriasis. However, the association between psoriasis and schizophrenia is less clear. Here, we investigated whether the prevalence of schizophrenia is higher in patients with psoriasis. Methods In this cross-sectional study, we analyzed the 1-million-person cohort enrolled from Taiwan's National Health Insurance Research Database. Psoriasis, schizophrenia, and comorbidities were ascertained by the International Classification of Diseases, 9th revision, Clinical Modification coding. For schizophrenia, the concomitant catastrophic illness certificate was used to verify the diagnosis. The prevalence of schizophrenia in patients with psoriasis was compared with the prevalence of schizophrenia in a comparable population using a generalized linear mixed model. Results The prevalence of schizophrenia was significantly higher in patients with psoriasis than in the comparison population [prevalence ratio = 1.77, 95% confidence interval (CI) = 1.48–2.12, p < 0.0001)]. Within the psoriasis cohort, patients aged between 40 years and 59 years had a higher odds ratio (OR) for schizophrenia (OR = 2.49, 95% CI = 1.55–4.00, p = 0.0002). Furthermore, psoriatic patients with comorbid cerebrovascular disease (OR = 2.01, 95% CI = 1.11–3.65, p = 0.0220) and chronic pulmonary disease (OR = 1.64, 95% CI = 1.07–2.49, p = 0.0218) had higher odds for schizophrenia. Conclusion Schizophrenia is more prevalent in patients with psoriasis. Although the exact mechanisms remain to be clarified, the finding that psoriatic patients with comorbid cerebrovascular disease or chronic pulmonary disease have higher odds for schizophrenia may imply psoriatic patients with those comorbidities are likely to have higher inflammatory burden, which would contribute to the development of schizophrenia if a disruption of the blood–brain barrier is present. Further investigations are indicated to validate the hypothesis explaining the association between known comorbidies of psoriasis and schizophrenia.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalDermatologica Sinica
Volume35
Issue number1
DOIs
Publication statusPublished - Mar 1 2017

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Psoriasis
Schizophrenia
Odds Ratio
Confidence Intervals
Cerebrovascular Disorders
Lung Diseases
Comorbidity
Catastrophic Illness
Chronic Disease
National Health Programs
International Classification of Diseases
Taiwan
Clinical Coding
Population
Psychiatry
Linear Models
Anxiety
Cross-Sectional Studies
Databases
Depression

Keywords

  • comorbidity
  • estrogen
  • psoriasis
  • schizophrenia
  • Th17 cell

ASJC Scopus subject areas

  • Dermatology

Cite this

Prevalence of schizophrenia in patients with psoriasis : a nationwide study. / Tu, Hung Pin; Yu, Chu Ling; Lan, Cheng Che E; Yu, Sebastian.

In: Dermatologica Sinica, Vol. 35, No. 1, 01.03.2017, p. 1-6.

Research output: Contribution to journalArticle

Tu, Hung Pin ; Yu, Chu Ling ; Lan, Cheng Che E ; Yu, Sebastian. / Prevalence of schizophrenia in patients with psoriasis : a nationwide study. In: Dermatologica Sinica. 2017 ; Vol. 35, No. 1. pp. 1-6.
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abstract = "Background/Objective The prevalence of selected psychiatric disorders, such as depression and anxiety, is higher in patients with psoriasis. However, the association between psoriasis and schizophrenia is less clear. Here, we investigated whether the prevalence of schizophrenia is higher in patients with psoriasis. Methods In this cross-sectional study, we analyzed the 1-million-person cohort enrolled from Taiwan's National Health Insurance Research Database. Psoriasis, schizophrenia, and comorbidities were ascertained by the International Classification of Diseases, 9th revision, Clinical Modification coding. For schizophrenia, the concomitant catastrophic illness certificate was used to verify the diagnosis. The prevalence of schizophrenia in patients with psoriasis was compared with the prevalence of schizophrenia in a comparable population using a generalized linear mixed model. Results The prevalence of schizophrenia was significantly higher in patients with psoriasis than in the comparison population [prevalence ratio = 1.77, 95{\%} confidence interval (CI) = 1.48–2.12, p < 0.0001)]. Within the psoriasis cohort, patients aged between 40 years and 59 years had a higher odds ratio (OR) for schizophrenia (OR = 2.49, 95{\%} CI = 1.55–4.00, p = 0.0002). Furthermore, psoriatic patients with comorbid cerebrovascular disease (OR = 2.01, 95{\%} CI = 1.11–3.65, p = 0.0220) and chronic pulmonary disease (OR = 1.64, 95{\%} CI = 1.07–2.49, p = 0.0218) had higher odds for schizophrenia. Conclusion Schizophrenia is more prevalent in patients with psoriasis. Although the exact mechanisms remain to be clarified, the finding that psoriatic patients with comorbid cerebrovascular disease or chronic pulmonary disease have higher odds for schizophrenia may imply psoriatic patients with those comorbidities are likely to have higher inflammatory burden, which would contribute to the development of schizophrenia if a disruption of the blood–brain barrier is present. Further investigations are indicated to validate the hypothesis explaining the association between known comorbidies of psoriasis and schizophrenia.",
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N2 - Background/Objective The prevalence of selected psychiatric disorders, such as depression and anxiety, is higher in patients with psoriasis. However, the association between psoriasis and schizophrenia is less clear. Here, we investigated whether the prevalence of schizophrenia is higher in patients with psoriasis. Methods In this cross-sectional study, we analyzed the 1-million-person cohort enrolled from Taiwan's National Health Insurance Research Database. Psoriasis, schizophrenia, and comorbidities were ascertained by the International Classification of Diseases, 9th revision, Clinical Modification coding. For schizophrenia, the concomitant catastrophic illness certificate was used to verify the diagnosis. The prevalence of schizophrenia in patients with psoriasis was compared with the prevalence of schizophrenia in a comparable population using a generalized linear mixed model. Results The prevalence of schizophrenia was significantly higher in patients with psoriasis than in the comparison population [prevalence ratio = 1.77, 95% confidence interval (CI) = 1.48–2.12, p < 0.0001)]. Within the psoriasis cohort, patients aged between 40 years and 59 years had a higher odds ratio (OR) for schizophrenia (OR = 2.49, 95% CI = 1.55–4.00, p = 0.0002). Furthermore, psoriatic patients with comorbid cerebrovascular disease (OR = 2.01, 95% CI = 1.11–3.65, p = 0.0220) and chronic pulmonary disease (OR = 1.64, 95% CI = 1.07–2.49, p = 0.0218) had higher odds for schizophrenia. Conclusion Schizophrenia is more prevalent in patients with psoriasis. Although the exact mechanisms remain to be clarified, the finding that psoriatic patients with comorbid cerebrovascular disease or chronic pulmonary disease have higher odds for schizophrenia may imply psoriatic patients with those comorbidities are likely to have higher inflammatory burden, which would contribute to the development of schizophrenia if a disruption of the blood–brain barrier is present. Further investigations are indicated to validate the hypothesis explaining the association between known comorbidies of psoriasis and schizophrenia.

AB - Background/Objective The prevalence of selected psychiatric disorders, such as depression and anxiety, is higher in patients with psoriasis. However, the association between psoriasis and schizophrenia is less clear. Here, we investigated whether the prevalence of schizophrenia is higher in patients with psoriasis. Methods In this cross-sectional study, we analyzed the 1-million-person cohort enrolled from Taiwan's National Health Insurance Research Database. Psoriasis, schizophrenia, and comorbidities were ascertained by the International Classification of Diseases, 9th revision, Clinical Modification coding. For schizophrenia, the concomitant catastrophic illness certificate was used to verify the diagnosis. The prevalence of schizophrenia in patients with psoriasis was compared with the prevalence of schizophrenia in a comparable population using a generalized linear mixed model. Results The prevalence of schizophrenia was significantly higher in patients with psoriasis than in the comparison population [prevalence ratio = 1.77, 95% confidence interval (CI) = 1.48–2.12, p < 0.0001)]. Within the psoriasis cohort, patients aged between 40 years and 59 years had a higher odds ratio (OR) for schizophrenia (OR = 2.49, 95% CI = 1.55–4.00, p = 0.0002). Furthermore, psoriatic patients with comorbid cerebrovascular disease (OR = 2.01, 95% CI = 1.11–3.65, p = 0.0220) and chronic pulmonary disease (OR = 1.64, 95% CI = 1.07–2.49, p = 0.0218) had higher odds for schizophrenia. Conclusion Schizophrenia is more prevalent in patients with psoriasis. Although the exact mechanisms remain to be clarified, the finding that psoriatic patients with comorbid cerebrovascular disease or chronic pulmonary disease have higher odds for schizophrenia may imply psoriatic patients with those comorbidities are likely to have higher inflammatory burden, which would contribute to the development of schizophrenia if a disruption of the blood–brain barrier is present. Further investigations are indicated to validate the hypothesis explaining the association between known comorbidies of psoriasis and schizophrenia.

KW - comorbidity

KW - estrogen

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KW - schizophrenia

KW - Th17 cell

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