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Association between prior somatic disease and 5-year relapse risk among 11,856 incident patients with schizophrenia

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@article{451e8ce1febf49dd9d4360621a9e1559,
title = "Association between prior somatic disease and 5-year relapse risk among 11,856 incident patients with schizophrenia",
abstract = "BACKGROUND: Somatic diseases have been associated with an increased risk for subsequent schizophrenia; however, it is unknown whether prior somatic diseases negatively affect early treatment outcomes after a first-time schizophrenia diagnosis.METHODS: We included all individuals born in Denmark after January 1st, 1977 and first-time diagnosed with schizophrenia between January 1st, 1996 and December 31st, 2015. We identified all life-time somatic hospital contacts and all prescriptions within the year before the first-time schizophrenia diagnosis and followed patients for up to five years regarding risk for schizophrenia (re)-hospitalization (relapse). We performed Cox regression analyses calculating hazard rate ratios (HRR) including 95{\%}-confidence intervals (CI) and adjusted for relevant confounders.RESULTS: We followed a total of 11,856 patients with a first-time schizophrenia diagnosis (58.7{\%} male, mean age 23.1 (SD = 4.7) years) for 39,033 person-years, whereof 5506 (46.4{\%}) had relapse with schizophrenia re-hospitalization during 5-year of follow-up. Somatic hospital contacts ever before (95.4{\%}; HRR = 1.30; 95{\%}-CI = 1.07-1.59), and specifically during the year before schizophrenia diagnosis (42.5{\%}; HRR = 1.36; 95{\%}-CI = 1.11-1.66) were associated with an increased risk of schizophrenia relapse as were a greater number of prior somatic hospital contacts (p < 0.001). Individuals with up to four different prescriptions for somatic medications showed a trend towards a slightly lower risk of relapse.CONCLUSION: Somatic diseases and health seeking patterns might have an impact on the course of schizophrenia, where severe somatic comorbidity, specifically during the year before first-time schizophrenia diagnosis, seem to negatively affect early treatment course, whereas previous somatic medication use may indicate a better compliance and help-seeking behavior.",
author = "Ole K{\"o}hler-Forsberg and S{\o}rensen, {Holger J} and Benros, {Michael E} and Liselotte Petersen and Christiane Gasse",
note = "Copyright {\circledC} 2019 Elsevier Masson SAS. All rights reserved.",
year = "2019",
month = "6",
doi = "10.1016/j.eurpsy.2019.03.006",
language = "English",
volume = "59",
pages = "1--7",
journal = "European Psychiatry",
issn = "0924-9338",
publisher = "Elsevier France Editions Scientifiques et Medicales",

}

RIS

TY - JOUR

T1 - Association between prior somatic disease and 5-year relapse risk among 11,856 incident patients with schizophrenia

AU - Köhler-Forsberg, Ole

AU - Sørensen, Holger J

AU - Benros, Michael E

AU - Petersen, Liselotte

AU - Gasse, Christiane

N1 - Copyright © 2019 Elsevier Masson SAS. All rights reserved.

PY - 2019/6

Y1 - 2019/6

N2 - BACKGROUND: Somatic diseases have been associated with an increased risk for subsequent schizophrenia; however, it is unknown whether prior somatic diseases negatively affect early treatment outcomes after a first-time schizophrenia diagnosis.METHODS: We included all individuals born in Denmark after January 1st, 1977 and first-time diagnosed with schizophrenia between January 1st, 1996 and December 31st, 2015. We identified all life-time somatic hospital contacts and all prescriptions within the year before the first-time schizophrenia diagnosis and followed patients for up to five years regarding risk for schizophrenia (re)-hospitalization (relapse). We performed Cox regression analyses calculating hazard rate ratios (HRR) including 95%-confidence intervals (CI) and adjusted for relevant confounders.RESULTS: We followed a total of 11,856 patients with a first-time schizophrenia diagnosis (58.7% male, mean age 23.1 (SD = 4.7) years) for 39,033 person-years, whereof 5506 (46.4%) had relapse with schizophrenia re-hospitalization during 5-year of follow-up. Somatic hospital contacts ever before (95.4%; HRR = 1.30; 95%-CI = 1.07-1.59), and specifically during the year before schizophrenia diagnosis (42.5%; HRR = 1.36; 95%-CI = 1.11-1.66) were associated with an increased risk of schizophrenia relapse as were a greater number of prior somatic hospital contacts (p < 0.001). Individuals with up to four different prescriptions for somatic medications showed a trend towards a slightly lower risk of relapse.CONCLUSION: Somatic diseases and health seeking patterns might have an impact on the course of schizophrenia, where severe somatic comorbidity, specifically during the year before first-time schizophrenia diagnosis, seem to negatively affect early treatment course, whereas previous somatic medication use may indicate a better compliance and help-seeking behavior.

AB - BACKGROUND: Somatic diseases have been associated with an increased risk for subsequent schizophrenia; however, it is unknown whether prior somatic diseases negatively affect early treatment outcomes after a first-time schizophrenia diagnosis.METHODS: We included all individuals born in Denmark after January 1st, 1977 and first-time diagnosed with schizophrenia between January 1st, 1996 and December 31st, 2015. We identified all life-time somatic hospital contacts and all prescriptions within the year before the first-time schizophrenia diagnosis and followed patients for up to five years regarding risk for schizophrenia (re)-hospitalization (relapse). We performed Cox regression analyses calculating hazard rate ratios (HRR) including 95%-confidence intervals (CI) and adjusted for relevant confounders.RESULTS: We followed a total of 11,856 patients with a first-time schizophrenia diagnosis (58.7% male, mean age 23.1 (SD = 4.7) years) for 39,033 person-years, whereof 5506 (46.4%) had relapse with schizophrenia re-hospitalization during 5-year of follow-up. Somatic hospital contacts ever before (95.4%; HRR = 1.30; 95%-CI = 1.07-1.59), and specifically during the year before schizophrenia diagnosis (42.5%; HRR = 1.36; 95%-CI = 1.11-1.66) were associated with an increased risk of schizophrenia relapse as were a greater number of prior somatic hospital contacts (p < 0.001). Individuals with up to four different prescriptions for somatic medications showed a trend towards a slightly lower risk of relapse.CONCLUSION: Somatic diseases and health seeking patterns might have an impact on the course of schizophrenia, where severe somatic comorbidity, specifically during the year before first-time schizophrenia diagnosis, seem to negatively affect early treatment course, whereas previous somatic medication use may indicate a better compliance and help-seeking behavior.

U2 - 10.1016/j.eurpsy.2019.03.006

DO - 10.1016/j.eurpsy.2019.03.006

M3 - Journal article

VL - 59

SP - 1

EP - 7

JO - European Psychiatry

JF - European Psychiatry

SN - 0924-9338

ER -

ID: 57461400