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Bidirectional relation between schizophrenia and epilepsy: A population-based retrospective cohort study

  1. Yu-Tzu Chang1,2,
  2. Pei-Chun Chen3,4,
  3. I-Ju Tsai3,4,
  4. Fung-Chang Sung3,4,
  5. Zheng-Nan Chin1,
  6. Huang-Tsung Kuo1,
  7. Chang-Hai Tsai1,5,
  8. I-Ching Chou1,5,6

Article first published online: 19 SEP 2011

DOI: 10.1111/j.1528-1167.2011.03268.x

Issue

Epilepsia

Epilepsia

Volume 52, Issue 11, pages 2036–2042, November 2011

Additional Information

How to Cite

Chang, Y.-T., Chen, P.-C., Tsai, I.-J., Sung, F.-C., Chin, Z.-N., Kuo, H.-T., Tsai, C.-H. and Chou, I.-C. (2011), Bidirectional relation between schizophrenia and epilepsy: A population-based retrospective cohort study. Epilepsia, 52: 2036–2042. doi: 10.1111/j.1528-1167.2011.03268.x

Author Information

  1. 1

    Division of Pediatric Neurology, Department of Pediatrics, China Medical University and Hospital, Taichung, Taiwan

  2. 2

    China Medical University, Taichung, Taiwan

  3. 3

    Management Office for Health Data, China Medical University and Hospital, Taichung, Taiwan

  4. 4

    Department of Public Health, China Medical University and Hospital, Taichung, Taiwan

  5. 5

    Department of Healthcare Administration, Asia University, Taichung, Taiwan

  6. 6

    Graduate Institute of Integrated Medicine, China Medical University College of Chinese Medicine, Taichung, Taiwan

*Address correspondence to I-Ching Chou, Division of Pediatric Neurology, Department of Pediatrics, Children’s Medical Center, China Medical University Hospital, No. 2, Yuh-Der Road, North District, Taichung 40402, Taiwan. E-mail: iching@mail.cmuh.org.tw. Pei-Chun Chen, Ph.D. MSPH, Department of Public Health, China Medical University and Hospital, No. 091, Hsueh-Shih Road, Taichung 40442, Taiwan. E-mail: tw.mohd@gmail.com

  1. Drs. Chen and Chou contributed equally to this work.

Publication History

  1. Issue published online: 27 OCT 2011
  2. Article first published online: 19 SEP 2011
  3. Accepted August 2, 2011; Early View publication September 19, 2011.

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Keywords:

  • Bidirectional relation;
  • Epilepsy;
  • Incidence;
  • Schizophrenia

Summary

Purpose:  Schizophrenia and epilepsy may share a mutual susceptibility. This study examined the bidirectional relation between the two disorders.

Methods:  We used claims data obtained from the Taiwan National Health Insurance database to conduct retrospective cohort analyses. Analysis 1 compared 5,195 patients with incident schizophrenia diagnosed in 1999–2008 with 20,776 controls without the disease randomly selected during the same period, frequency matched with sex and age. Analysis 2 comprised a similar method to compare 11,527 patients with newly diagnosed epilepsy with 46,032 randomly selected sex- and age-matched controls. At the end of 2008, analysis 1 measured the incidence and risk of developing epilepsy and analysis 2 measured the incidence and risk of developing schizophrenia.

Key Findings:  In analysis 1, the incidence of epilepsy was higher in the schizophrenia cohort than in the nonschizophrenia cohort (6.99 vs. 1.19 per 1,000 person-years) with an adjusted hazard ratio (aHR) of 5.88 [95% confidence interval (CI) 4.71–7.36] for schizophrenia patients. In analysis 2, the incidence of schizophrenia was higher in the epilepsy cohort than in the nonepilepsy comparison cohort (3.53 vs. 0.46 per 1,000 person-years) with an aHR of 7.65 (95% CI 6.04–9.69) for epilepsy patients. The effect of schizophrenia on subsequent epilepsy was greater for women, but the association between epilepsy and elevated incidence of schizophrenia was more pronounced in men.

Significance:  We found a strong bidirectional relation between schizophrenia and epilepsy. These two conditions may share common causes. Further studies on the mechanism are required.

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