title: Schizophrenia among patients with systemic lupus erythematosus: population-based cross-sectional study.
abstract: Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease involving multiple organs, including the central nervous system. Evidence of immune dysfunction exists also in schizophrenia, a psychiatric illness involving chronic or recurrent psychosis. The aim of our study was to investigate if there is an epidemiological association between SLE and schizophrenia.
  
  
  
  A cross-sectional study was conducted comparing patients with SLE with age and gender-matched controls regarding the proportion of patients with comorbid schizophrenia. χ 2- and t-tests were used for univariate analysis, and interaction of schizophrenia with SLE across strata of covariates was checked. A logistic regression model was used for multivariate analysis. The study was performed utilising the medical database of Clalit Health Services in Israel.
  
  
  
  The study included 5018 patients with SLE and 25 090 controls. SLE patients had a female predominance, and a higher proportion of smoking compared with age and sex-matched controls. In multivariate analysis, SLE was found to be independently associated with schizophrenia while controlling for age, gender, socioeconomic status (SES) and smoking (OR 1.33, p = 0.042).
  
  
  
  We found a positive association between SLE and schizophrenia across patients of different age, gender and SES. This association can contribute to understanding the pathophysiology of the two disorders and may also have clinical implications for earlier as well as better diagnosis and treatment.
authors.affiliation: Department of Medicine 'B',Sheba Medical Center,Tel-Hashomer,Israel.
authors.forename: S
authors.identifier: 0000-0002-1748-4297
authors.initials: S
authors.lastname: Tiosano
authors.affiliation: Department of Medicine 'B',Sheba Medical Center,Tel-Hashomer,Israel.
authors.forename: A
authors.initials: A
authors.lastname: Farhi
authors.affiliation: Department of Medicine 'B',Sheba Medical Center,Tel-Hashomer,Israel.
authors.forename: A
authors.initials: A
authors.lastname: Watad
authors.affiliation: Department of Medicine 'B',Sheba Medical Center,Tel-Hashomer,Israel.
authors.forename: N
authors.initials: N
authors.lastname: Grysman
authors.affiliation: Sackler Faculty of Medicine,Tel-Aviv University,Tel-Aviv,Israel.
authors.forename: R
authors.initials: R
authors.lastname: Stryjer
authors.affiliation: Department of Medicine 'B',Sheba Medical Center,Tel-Hashomer,Israel.
authors.forename: H
authors.initials: H
authors.lastname: Amital
authors.affiliation: Chief Physician's Office,Clalit Health Services Tel Aviv,Tel-Aviv,Israel.
authors.forename: D
authors.initials: D
authors.lastname: Comaneshter
authors.affiliation: Chief Physician's Office,Clalit Health Services Tel Aviv,Tel-Aviv,Israel.
authors.forename: A D
authors.initials: AD
authors.lastname: Cohen
authors.affiliation: Sackler Faculty of Medicine,Tel-Aviv University,Tel-Aviv,Israel.
authors.forename: D
authors.initials: D
authors.lastname: Amital
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011618:Psychotic Disorders / Q000453:epidemiology*; D012559:Schizophrenia / Q000453:epidemiology*; D017678:Sex Distribution; D012959:Socioeconomic Factors
keywords: Autoimmune disease; SLE; Schizophrenia; autoimmunity; psychosis