Increased risk of chronic liver disease in patients with schizophrenia: a population-based cohort study.
OBJECTIVE
To investigate the prevalence and incidence of chronic liver disease in patients with schizophrenia in Taiwan.


METHODS
We used a random sample of 661,266 subjects aged ≥ 18 from the National Health Research Institute database in the year 2000. Subjects with at least one primary diagnosis of schizophrenia (The International Classification of Diseases, Ninth Revision, Clinical Modification: 295) in 2000 were selected. Patients with a primary or secondary diagnosis of chronic liver disease (The International Classification of Diseases, Ninth Revision, Clinical Modification: 571) were also defined. We compared the prevalence and associated factors of chronic liver disease between patients with schizophrenia and the general population in 2000. We also compared the incidence of chronic liver disease in patients with schizophrenia and the general population from 2001 through 2010.


RESULTS
The prevalence of chronic liver disease in patients with schizophrenia (7.0%) was 1.27 times as high as that of the general population (6.1%) in 2000. The average annual incidence of chronic liver disease in patients with schizophrenia from 2001-2010 was also higher than that of the general population (2.9% vs 2.5%, risk ratio, 1.15; 95% confidence interval, 1.07-1.24). Younger patients with schizophrenia were found to have a much higher prevalence and incidence than those in the general population, and diabetes was a risk factor for patients with schizophrenia in developing chronic liver disease.


CONCLUSIONS
Patients with schizophrenia exhibited a significantly higher prevalence and incidence of chronic liver disease than those in the general population, and younger patients with schizophrenia have a much higher prevalence and incidence than those in the general population. Co-morbidity with diabetes was the primary risk factor for patients with schizophrenia to develop chronic liver disease.
Chia-Yi Hospital, Department of Health, Chiayi, Taiwan.
Jer-Hwa
JH
Hsu
Taoyuan Mental Hospital, Department of Health, Taoyuan, Taiwan; Department of Public Health and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. Electronic address: icchien@typc.doh.gov.tw.
I-Chia
IC
Chien
Taichung Veteran General Hospital, Taichung, Taiwan.
Ching-Heng
CH
Lin
Department of Public Health and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
Yiing-Jenq
YJ
Chou
Department of Public Health and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Community Medicine Research Center, National Yang-Ming university, Taipei, Taiwan.
Pesus
P
Chou
D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002908:Chronic Disease; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005235:Fatty Liver, Alcoholic / Q000453:epidemiology; D005260:Female; D006519:Hepatitis, Alcoholic / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008104:Liver Cirrhosis, Alcoholic / Q000453:epidemiology; D008105:Liver Cirrhosis, Biliary / Q000453:epidemiology; D008107:Liver Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
D014150:Antipsychotic Agents