title: Bidirectional relation between schizophrenia and epilepsy: a population-based retrospective cohort study.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  We found a strong bidirectional relation between schizophrenia and epilepsy. These two conditions may share common causes. Further studies on the mechanism are required.
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, China Medical University and Hospital, Taichung, Taiwan.
authors.forename: Yu-Tzu
authors.initials: YT
authors.lastname: Chang
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Chen
authors.forename: I-Ju
authors.initials: IJ
authors.lastname: Tsai
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.forename: Zheng-Nan
authors.initials: ZN
authors.lastname: Chin
authors.forename: Huang-Tsung
authors.initials: HT
authors.lastname: Kuo
authors.forename: Chang-Hai
authors.initials: CH
authors.lastname: Tsai
authors.forename: I-Ching
authors.initials: IC
authors.lastname: Chou
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D002648:Child; D004827:Epilepsy / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology* / Q000209:etiology; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult