Longitudinal association between epilepsy and schizophrenia:A population-based study |
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| Institution: | 1. IDF Medical Corps, Israel;2. Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel;3. Institute of Psychiatry, King''s College London, London, England, UK;4. Department of Mental Health, Ministry of Health, Israel;5. Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel;1. Department of Pedagogy and Psychology, Pedagogical Faculty, University of South Bohemia, Dukelska 7, 371 15 Ceske Budejovice, Czech Republic;2. Department of Pediatric Neurology, Charles University in Prague, 2nd Faculty of Medicine, Motol University Hospital, Praha, Czech Republic;3. Department of Physics, Faculty of Applied Sciences, University of West Bohemia, Plzen, Czech Republic;4. Thomayer''s Hospital, Praha, Czech Republic;1. Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University, USA;2. Division of Educational Studies, Emory University, USA;3. Department of Sociology, Georgia State University, USA;1. Disciplina de Neurologia Experimental, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil;2. Edinburgh and South East Scotland Epilepsy Service, Department of Clinical Neurosciences, Western General Hospital, Edinburgh, Scotland, UK;3. Departamento de Psicobiologia, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil |
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| 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 ± 1.0 years (range: 1.0–10.0 years). 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. |
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