title: Incidence and outcome of newly-diagnosed tuberculosis in schizophrenics: a 12-year, nationwide, retrospective longitudinal study.
abstract: BACKGROUND
  To control tuberculosis (TB), it is critical to identify at risk populations. Schizophrenia is recognized as an important risk factor for TB. However, previous studies have been confounded by comorbidities, and reports of TB infection outcomes are rare. Therefore, the current nation-wide study aimed to compare the adjusted incidence and outcome of TB diseases in schizophrenics and the general population.
  
  
  METHODS
  Using the National Health Insurance Research Database from 1998 to 2009, this retrospective longitudinal study included 60,409 schizophrenics and general population matched for age, Charlson's score, and comorbidities. Diagnosis of TB was based on the international classification of disease, ninth revision and use of anti-TB drugs. Unfavorable outcome for TB was defined as death, loss to follow-up, or use of anti-TB treatment for more than 9 months.
  
  
  RESULTS
  The adjusted incidence of TB in schizophrenics was significantly higher than in the general population [hazard ratio, 1.52; 95% confidence interval (CI), 1.29-1.79; p < 0.001; Kaplan-Meier log-rank test, p < 0.001]. Cox regression revealed age and male gender as risk factors for newly-diagnosed TB. The outcome of TB was comparable in schizophrenics and the general population [odds ratio (OR), 0.78; 95% CI, 0.55-1.09; p =0.144]. Logistic regression revealed a statistical trend for diabetes mellitus to predict poor outcome in schizophrenics with TB (OR, 2.30; 95% CI, 0.96-5.74; p = 0.062).
  
  
  CONCLUSIONS
  Schizophrenics are at increased risk for TB, and screening may be warranted for those living in areas with high prevalence of TB.
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan.
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Kuo
authors.forename: Yung-Tai
authors.initials: YT
authors.lastname: Chen
authors.forename: Szu-Yuan
authors.initials: SY
authors.lastname: Li
authors.forename: Yi-Tzu
authors.initials: YT
authors.lastname: Lee
authors.forename: Albert C
authors.initials: AC
authors.lastname: Yang
authors.forename: Te-Li
authors.initials: TL
authors.lastname: Chen
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Ih-Jen
authors.initials: IJ
authors.lastname: Su
authors.forename: Chang-Phone
authors.initials: CP
authors.lastname: Fung
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012559:Schizophrenia / Q000453:epidemiology* / Q000382:microbiology; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000995:Antitubercular Agents
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