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Comorbidity of schizophrenia and infection: a population-based cohort study

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

In this paper, we investigate the hypothesis that there is an overlap between infection and schizophrenia. Infections have been identified as a risk factor for schizophrenia, but the possible overlap between schizophrenia and infections remains unidentified so far. Here, we describe the use of the comorbidity index, a method for objectively integrating associations into a single measure estimating overlap.

Methods

Data were drawn from three population-based registers, the Civil Registration Register, the Danish Psychiatric Central Research Register, and the Danish National Hospital Register. We selected a cohort of 1,403,183 persons born in Denmark 1977–2002.

Results

Our results indicate that persons who have had a hospital contact with an infection (IRR 1.53, CI 1.46–1.61) are more likely to develop schizophrenia than persons who have not had such a contact. Persons who have had a diagnosis with schizophrenia are more likely to have had a hospital contact with an infection (IRR 1.73, 95 % CI 1.57–1.91) than persons who have had no schizophrenia diagnosis. A comorbidity index of 1.40 (95 % CI 1.34–1.46) was found, indicating an overlap between schizophrenia and infection.

Conclusion

Our findings indicate that schizophrenia and infections overlap and that they share risk factors. The comorbidity index showed that the co-occurrence of schizophrenia and infection was 40 % higher than if the two disorders had occurred independently. Although the incidence of schizophrenia and infection was associated with each factor, the overlap could not be explained by urbanicity, parental history of psychiatric admission and infection.

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Acknowledgments

This work was supported by unrestricted grants from the Lundbeck Foundation and Stanley Medical Research Institute.

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Authors and Affiliations

  1. National Centre for Register-based Research, Aarhus University, Fuglesangs Allé 4, 8210, Aarhus V, Denmark

    Philip Rising Nielsen, Thomas Munk Laursen & Esben Agerbo

  2. Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Fuglesangs Allé 4, Aarhus V, Denmark

    Philip Rising Nielsen, Thomas Munk Laursen & Esben Agerbo

  3. Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Fuglesangs Allé 4, Aarhus V, Denmark

    Esben Agerbo

Authors
  1. Philip Rising Nielsen
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  2. Thomas Munk Laursen
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Correspondence to Philip Rising Nielsen.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Nielsen, P.R., Laursen, T.M. & Agerbo, E. Comorbidity of schizophrenia and infection: a population-based cohort study. Soc Psychiatry Psychiatr Epidemiol 51, 1581–1589 (2016). https://doi.org/10.1007/s00127-016-1297-1

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  • DOI: https://doi.org/10.1007/s00127-016-1297-1

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