title: Longitudinal association between epilepsy and schizophrenia: a population-based study.
abstract: A large number of studies have reported an association between epilepsy and major psychiatric conditions. This study investigated the association between epilepsy and later schizophrenia, utilizing a historical-prospective, population-based design. Of the 861,062 17-year-old male adolescents consecutively screened by the Israeli Draft Board and found free of major mental illness, 0.06% suffered from severe, treatment-refractory epilepsy, 0.25% had treated, controlled epilepsy, and 0.16% had a history of seizures which had abated 5 or more years prior to screening. Hospitalization for schizophrenia was ascertained through the Israeli National Psychiatric Hospitalization Case Registry, with an average follow-up of 9.6±1.0years (range: 1.0-10.0years). Risk of hospitalization was calculated using Cox regression analyses, compared to socioeconomic-adjusted risk of hospitalization in the general population of male adolescents. Among adolescents whose epilepsy was nonresponsive to medication, the adjusted risk of hospitalization was significantly increased for schizophrenia (HR=3.89, 95% CI=1.75-89.67). Male adolescents with successfully treated epilepsy were not at increased risk for schizophrenia. Male adolescents with severe, treatment-refractory epilepsy are at increased risk of later schizophrenia. Future studies attempting to understand the biology of this association might focus on this subset of patients, and these patients should be monitored for the appearance of psychosis.
authors.affiliation: IDF Medical Corps, Israel. Electronic address: frueyal@gmail.com.
authors.forename: Eyal
authors.initials: E
authors.lastname: Fruchter
authors.affiliation: Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel. Electronic address: orikapara@hotmail.com.
authors.forename: Ori
authors.initials: O
authors.lastname: Kapara
authors.affiliation: Institute of Psychiatry, King's College London, London, England, UK. Electronic address: avi.reichenberg@kcl.ac.uk.
authors.forename: Avi
authors.initials: A
authors.lastname: Reichenberg
authors.affiliation: Department of Mental Health, Ministry of Health, Israel. Electronic address: rinat.yoffe@moh.health.gov.il.
authors.forename: Rinat
authors.initials: R
authors.lastname: Yoffe
authors.affiliation: IDF Medical Corps, Israel. Electronic address: oshratf@012.net.il.
authors.forename: Oshrat
authors.initials: O
authors.lastname: Fono-Yativ
authors.affiliation: IDF Medical Corps, Israel. Electronic address: ykreiss@gmail.com.
authors.forename: Yitshak
authors.initials: Y
authors.lastname: Kreiss
authors.affiliation: IDF Medical Corps, Israel; Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel. Electronic address: mdavidson6@gmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Davidson
authors.affiliation: IDF Medical Corps, Israel; Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel; Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel. Electronic address: mweiser@netvision.net.il.
authors.forename: Mark
authors.initials: M
authors.lastname: Weiser
mesh_terms: D000293:Adolescent; D018672:Community Health Planning; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D012042:Registries / Q000706:statistics & numerical data; D012044:Regression Analysis; D012559:Schizophrenia / Q000453:epidemiology*
keywords: Epidemiology; Epilepsy; Schizophrenia