Incidence Rates and Risk of Hospital Registered Infections among Schizophrenia Patients before and after Onset of Illness: A Population-Based Nationwide Register Study

Abstract

Infections in schizophrenia patients are associated with an increased premature mortality. However, our knowledge about the burden of infections in schizophrenia is scarce. The aims of this study were to (1) determine the prevalence of clinically important hospital registered infections in the period of five years prior to and five years after the diagnosis, (2) estimate the risk of infections before and after the schizophrenia diagnosis and, (3) evaluate the impact of comorbidity on the risk of infections in schizophrenia. Using combined data from Danish national registers, we sampled a cohort of all persons born in Denmark in the period 1975–1990 and obtained health-related records from 1995–2013. Occurrence patterns and the risk of infections were measured as annual incidence rates and incidence rates ratios, estimated using Poisson models. Medical conditions from the Charlson Index were considered as a measure of comorbidity. The analyses showed that schizophrenia patients had a significantly elevated risk of almost all types of hospital registered infections during the period of the study when compared to the controls. Comorbidity increased rates of infections by 176%. The results suggest that the risk of infections is elevated in the schizophrenia population and physical illness is an important risk factor.

Pneumonia: host susceptibility and shared genetics with pulmonary function and other traits

“…Circulating plasma lipids are involved in the damage repair of inflammation cell membranes and interact with host cytokines and bacterial toxins , thus contributing to polygenic overlap between autoimmune disorders and blood lipids (triglycerides, low‐ and high‐density lipoproteins) . In several studies with concordant results on pneumonia and PF association with mental illness , specific lifestyle‐ and health‐related conditions underlying these associations were pointed out. Only one investigation mentioned the possible role of genetics in the association of pneumonia and schizophrenia .…”

“…One of the major risk factors for pneumonia is deterioration of lung function. A bidirectional relationship is assumed between pneumonia and other illnesses : chronic respiratory diseases , cardiovascular disease , neurocognitive decline and skeletal muscle dysfunction . All these conditions are also associated with attenuated lung function.…”

“… Table S3. Shared SNP‐level associations within the HLA region across pneumonia (in the 23andMe study ) and PF .…”

“… Table S4. LD data in Europeans for sentinel SNPs in the HLA region (one SNP per gene locus) from the list of overlapping SNPs in the 23andMe pneumonia and PF datasets .…”

Risk factors of major infections in schizophrenia. A nationwide Danish register study

“…In our previous work, we found that female gender was associated with elevated risk of infections in both schizophrenia patients and controls form the general population. However, the association between age and gender have not been evaluated (Pankiewicz-Dulacz et al 2018). Former literature reported higher risk of sexual transmitted infections in young females when compared to males, although differences in occurrence patterns between all spectrum of infectious diseases between genders in adolescence have not been sufficiently elucidated (Allen et al 2014).…”