Prevalence and associated factors of comorbid skin diseases in patients with schizophrenia: a clinical survey and national health database study.
OBJECTIVE
To examine the epidemiology of and possible risk factors for skin diseases in patients with schizophrenia.


METHODS
All of 337 patients with schizophrenia were recruited from the therapeutic community of a psychiatric hospital and underwent a detailed skin examination. The National Health Insurance Research Database (NHIRD) was used to compare the prevalence of skin diseases between patients with schizophrenia and those without.


RESULTS
In the clinical survey, fungal infection (61.4%) and dermatitis (46.9%) were the most common skin diseases. Clozapine users had a lower risk of fungal infection than those on typical antipsychotics [odds ratio (OR)=0.49, 95% confidence interval (CI)=0.30-0.81]. Obese patients were more likely to have fungal infections than those without (OR=1.93, 95% CI=1.20-3.09), and those with diabetes had an increased risk of bacterial infection than those without (OR=2.0, 95% CI=1.06-3.75). NHIRD revealed that the overall prevalence of skin diseases, including infections, dermatitis, hyperkeratosis, pilosebaceous disease, androgenic alopecia, xerosis and stasis, were higher in patients with schizophrenia than in those without (75.1% vs. 72.6%, P=.01).


CONCLUSIONS
The prevalence of skin diseases is high in patients with schizophrenia, for whom proper skin care is necessary to improve their life quality.
Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan (R.O.C.); Division of Preventive Medicine, Institute of Public Health, National Yang-Ming University, Taipei 112, Taiwan (R.O.C.).
Bai-Yao
BY
Wu
Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien 981, Taiwan (R.O.C.).
Bo-Jian
BJ
Wu
Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien 981, Taiwan (R.O.C.); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan (R.O.C.).
Shin-Min
SM
Lee
Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien 981, Taiwan (R.O.C.).
Hsiao-Ju
HJ
Sun
Department of Dermatology, Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan (R.O.C.); Department of Dermatology, Taipei Veterans General Hospital, Taipei 112, Taiwan (R.O.C.).
Yun-Ting
YT
Chang
Division of Preventive Medicine, Institute of Public Health, National Yang-Ming University, Taipei 112, Taiwan (R.O.C.). Electronic address: mwlin@ym.edu.tw.
Ming-Wei
MW
Lin
D000328:Adult; D015897:Comorbidity; D003881:Dermatomycoses / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology*; D012871:Skin Diseases / Q000453:epidemiology*; D017192:Skin Diseases, Bacterial / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology
Antipsychotics; Prevalence; Schizophrenia; Skin disease; Taiwan