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Schizophrenia among patients with systemic lupus erythematosus: population-based cross-sectional study

Published online by Cambridge University Press:  26 July 2016

S. Tiosano Open the ORCID record for S. Tiosano [Opens in a new window] ,
A. Farhi ,
A. Watad ,
N. Grysman ,
R. Stryjer ,
H. Amital ,
D. Comaneshter ,
A. D. Cohen  and
D. Amital
S. Tiosano
Affiliation:
Department of Medicine ‘B’, Sheba Medical Center, Tel-Hashomer, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
A. Farhi
Affiliation:
Department of Medicine ‘B’, Sheba Medical Center, Tel-Hashomer, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
A. Watad
Affiliation:
Department of Medicine ‘B’, Sheba Medical Center, Tel-Hashomer, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
N. Grysman
Affiliation:
Department of Medicine ‘B’, Sheba Medical Center, Tel-Hashomer, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
R. Stryjer
Affiliation:
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Beer-Yaakov Mental Health Center, Israel
H. Amital*
Affiliation:
Department of Medicine ‘B’, Sheba Medical Center, Tel-Hashomer, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
D. Comaneshter
Affiliation:
Chief Physician's Office, Clalit Health Services Tel Aviv, Tel-Aviv, Israel
A. D. Cohen
Affiliation:
Chief Physician's Office, Clalit Health Services Tel Aviv, Tel-Aviv, Israel Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben Gurion University of the Negev, Beer Sheva, Israel
D. Amital
Affiliation:
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Beer-Yaakov Mental Health Center, Israel
*
*Address for correspondence: H. Amital, Department of Medicine ‘B’, Sheba Medical Center, Tel-Hashomer, 5262100, Israel. (Email: [email protected])
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Abstract

Aims.

Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease involving multiple organs, including the central nervous system. Evidence of immune dysfunction exists also in schizophrenia, a psychiatric illness involving chronic or recurrent psychosis. The aim of our study was to investigate if there is an epidemiological association between SLE and schizophrenia.

Method.

A cross-sectional study was conducted comparing patients with SLE with age and gender-matched controls regarding the proportion of patients with comorbid schizophrenia. χ2- and t-tests were used for univariate analysis, and interaction of schizophrenia with SLE across strata of covariates was checked. A logistic regression model was used for multivariate analysis. The study was performed utilising the medical database of Clalit Health Services in Israel.

Results.

The study included 5018 patients with SLE and 25 090 controls. SLE patients had a female predominance, and a higher proportion of smoking compared with age and sex-matched controls. In multivariate analysis, SLE was found to be independently associated with schizophrenia while controlling for age, gender, socioeconomic status (SES) and smoking (OR 1.33, p = 0.042).

Conclusions.

We found a positive association between SLE and schizophrenia across patients of different age, gender and SES. This association can contribute to understanding the pathophysiology of the two disorders and may also have clinical implications for earlier as well as better diagnosis and treatment.

Keywords

Autoimmune diseaseautoimmunitypsychosisSLESchizophrenia
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 26 , Issue 4 , August 2017 , pp. 424 - 429
Copyright
Copyright © Cambridge University Press 2016 

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