Prevalence of Schizophrenia in Individuals With Type 2 Diabetes

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Schizophrenia is a chronic condition that is associated with significant morbidity and mortality.
Schizophrenia is a chronic condition that is associated with significant morbidity and mortality.

The prevalence of schizophrenia is higher in patients with type 2 diabetes mellitus (T2DM) compared with the general population, according to results of a study recently published in European Psychiatry.

Investigators conducted a retrospective cohort study using insurance claims data from enrollees in the Taiwan National Health Insurance Program. The study cohort comprised patients with T2DM and schizophrenia (n = 532), patients with T2DM without schizophrenia (n=61,835), and patients without either condition, termed the “general population” (n=715,756). Participants with schizophrenia had a record of at least 1 outpatient or inpatient service claim for a principal diagnosis of schizophrenia; patients with T2DM had at least 2 service claims for ambulatory care or 1 service claim for inpatient care for a principal diagnosis of T2DM. Investigators also captured numerous demographic characteristics including age, sex, residential area and urbanization level, income, comorbidities, duration of diabetes mellitus, and Charlson Comorbidity Index (CCI).

The 1-year prevalence rate of schizophrenia was significantly higher in the T2DM group (0.85%) compared with the general population (0.56%; P <.0001). The 1-year prevalence rate of schizophrenia remained high among patients with T2DM who had received oral antidiabetic therapy (0.84%) compared with the general population (P <.0001). Among patients with T2DM who had not received antidiabetic therapy, the prevalence of schizophrenia was even higher (0.91%). Following multiple logistic regression analyses, a high prevalence of schizophrenia was observed in patients with T2DM who were <60 years of age, particularly among those between the ages of 31 and 40 (adjusted odds ratio [AOR], 3.56; 95% CI, 1.42-8.93; P =.0069) and between the ages of 41 and 50 years (AOR, 3.98; 95% CI, 1.61-9.83; P =.0027). Additionally, among individuals with T2DM, higher prevalence of schizophrenia was associated with residence in eastern Taiwan (AOR, 2.29; 95% CI, 1.51-3.45; P <.0001), lower income levels (AORs between 5.33-13.74), and CCI >2 (AOR, 1.43; 95% CI, 1.05-1.94; P =.022).

These data suggest that the prevalence of schizophrenia is higher in patients with T2DM compared with the general population, and that this prevalence may increase based on a number of covariates. Clinicians should utilize these results to leverage appropriate care to at-risk patients.

Reference

Huang C-J, Hsieh H-M, Tu H-P, Jiang H-J, Wang P-W, Lin C-H. Schizophrenia in type 2 diabetes mellitus: prevalence and clinical characteristics. Eur Psychiatry. 2018;54:102-108.

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