title: Socio-environmental factors associated with diabetes mellitus among patients hospitalized with schizophrenia in Japan.
abstract: OBJECTIVE
  This study aimed to examine epidemiologically socio-environmental factors associated with diabetes mellitus among patients hospitalized with schizophrenia in Japan.
  
  
  METHODS
  This was a cross-sectional study from a single psychiatric hospital. Study patients were adults aged ≥20 years who were hospitalized with schizophrenia one or more times between January 2013 and December 2014. From electronic medical records or health insurance claims, we extracted schizophrenia patients with an F2 code according to ICD-10, and assessed the association of various factors with diabetes mellitus among these patients in a multivariable analysis.
  
  
  RESULTS
  During the 2-year period, there were 1899 patients hospitalized with a psychiatric disorder one or more times. Of them, a total of 770 adults with schizophrenia (285 men and 485 women) were eligible for our analysis. The standardized prevalence ratio of diabetes mellitus was 2.0 [95 % confidence interval (CI) 1.6-2.5] among men and 3.0 (95 % CI 2.5-3.6) among women in this hospital. There were no socio-environmental factors associated with diabetes mellitus among men. Among women, factors such as a 730-day hospitalization [adjusted odds ratio (OR) 3.82: 95 % confidence interval (CI) 1.52-9.64], and a medical protection/compulsory/discrimination hospitalization (adjusted OR 0.60, 95 % CI 0.36-0.99) were associated with diabetes mellitus. Compared with women living alone, those who were unmarried and lived together with someone had a significantly lower adjusted OR (0.41, 95 % CI 0.21-0.81).
  
  
  CONCLUSIONS
  Socio-environmental factors such as length of hospitalization, type of hospitalization, and marital status and living arrangement were associated with diabetes mellitus among hospitalized women with schizophrenia.
authors.affiliation: Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita, 565-0871, Osaka, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Sado
authors.affiliation: Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita, 565-0871, Osaka, Japan.
authors.forename: Tetsuhisa
authors.initials: T
authors.lastname: Kitamura
authors.affiliation: Social Welfare Corporation, Kosaka Hospital, 2-7-30 Eiwa, Higashi-Osaka, 577-0809, Osaka, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Noma
authors.affiliation: Social Welfare Corporation, Kosaka Hospital, 2-7-30 Eiwa, Higashi-Osaka, 577-0809, Osaka, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Saito
authors.affiliation: Social Welfare Corporation, Kosaka Hospital, 2-7-30 Eiwa, Higashi-Osaka, 577-0809, Osaka, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Azuma
authors.affiliation: Social Welfare Corporation, Kosaka Hospital, 2-7-30 Eiwa, Higashi-Osaka, 577-0809, Osaka, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Azuma
authors.affiliation: Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita, 565-0871, Osaka, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Sobue
authors.affiliation: Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita, 565-0871, Osaka, Japan. ytkitamura@envi.med.osaka-u.ac.jp.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Kitamura
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000453:epidemiology* / Q000209:etiology; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Diabetes mellitus; Schizophrenia; Socio-environmental factors