The Epidemiological Study of Physical Morbidity in Schizophrenics —2. Association between Schizophrenia and Incidence of Tuberculosis—

Ohta, Yasuyuki; Nakane, Yoshibumi; Mine, Mariko; Nakama, Ichiro; Michitsuji, Shunichiro; Araki, Kyohei; Tominaga, Yasunori; Uchino, Jun

doi:10.1111/j.1440-1819.1988.tb01954.x

Cited by 14 publications

(16 citation statements)

References 14 publications

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“…Other literatures have also documented high prevalence of mental health problems among people with HIV/AIDS [8,9] and patients with tuberculosis [12,13]. In the present study, the decline in prevalence of CMD at the 6 month of treatment and follow up was more marked among TB/HIV patients compare to people living with HIV without TB.…”

Section: Discussionsupporting

confidence: 59%

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Do common mental disorders decline over time in TB/HIV co-infected and HIV patients without TB who are on antiretroviral treatment?

Deribew

Deribe

Reda³

et al. 2013

BMC Psychiatry

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BackgroundThe relationship between TB/HIV co-infection and common mental disorders (CMD) is not well investigated. A follow up study was conducted to assess the change in CMD over a 6-months period and its predictors among TB/HIV co-infected and HIV patients without TB in Ethiopia.MethodsA longitudinal study was conducted in 2009. A total of 465 HIV/AIDS patients without TB and 124 TB/HIV co-infected patients from four antiretroviral treatment (ART) centers in Ethiopia were recruited to assess CMD and quality of life (QoL). CMD and QoL were assessed at baseline and at six month using the Kessler-10 scale and the short Amharic version of the World Health Organization Quality of Life Instrument for HIV clients (WHOQOL HIV-Bref) respectively. Multivariate analysis was conducted using generalized estimating equations (GEE) using STATA to assess change in CMD and its predictors.ResultsAt the 6 month, 540 (97 TB/HIV co-infected and 455 HIV/AIDS patients without TB) patients completed the follow up and 8.6% (21% among TB/HIV co-infected and 2.2% among HIV patients without TB) lost to follow-up.At baseline, 54.4% of TB/HIV co-infected patients had mild to severe mental disorder compared to 41.2% among HIV patients without TB. At the six month follow up, 18.1% of TB/HIV co-infected patients had mild to severe mental disorder compared to 21.8% among HIV patients without TB. The decline of the prevalence of any form of metal disorder was 36.3% among TB/HIV co-infected patients compared to 19.4% among HIV patients without TB (P<0.001).QoL was strongly associated with CMD in TB/HIV co-infected patients and HIV patients without TB (β = −0.04, P<0.001) after controlling the effect of several confounding variables such as sex, income, WHO disease stage, duration on ART, CD4 lymphocyte count, adherence to ART and social support.ConclusionThe prevalence of CMD has significantly reduced particularly among TB/HIV co-infected patients over a 6 months period. Poor QoL is the major independent predictors of CMD. We recommend integration of mental health services in TB/HIV programs. Training of health care providers at TB/HIV clinics could help to screen and treat CMD among TB/HIV co-infected patients.

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Section: Discussionsupporting

confidence: 59%

“…Few studies have documented high prevalence of tuberculosis among individuals with mental health problems [12,13]. In addition, high prevalence of depression was recorded among tuberculosis patients compared to health controls [14,15].…”

Section: Introductionmentioning

confidence: 99%

Do common mental disorders decline over time in TB/HIV co-infected and HIV patients without TB who are on antiretroviral treatment?

Deribew

Deribe

Reda³

et al. 2013

BMC Psychiatry

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“…Surprisingly, few epidemiological studies on the association between schizophrenia and bacterial infections were found. One Japanese study (17) found a higher incidence of tuberculosis among patients with schizophrenia compared with the general population. A similar result was found in a study from the United Kingdom (18), and reports from Israel (19) and Russia (20) also suggested elevated prevalences of bacterial infections and tuberculosis.…”

Section: Resultsmentioning

confidence: 99%

Physical illness and schizophrenia: a review of the literature

Leucht

Burkard

Henderson³

et al. 2007

Acta Psychiatr Scand

560

358

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Sartorius N. Physical illness and schizophrenia: a review of the literature.Objective: The lifespan of people with schizophrenia is shortened compared to the general population. We reviewed the literature on comorbid physical diseases in schizophrenia to provide a basis for initiatives to fight this unacceptable situation. Method: We searched MEDLINE (1966( -May 2006 combining the MeSH term of schizophrenia with the 23 MeSH terms of general physical disease categories to identify relevant epidemiological studies. Results: A total of 44 202 abstracts were screened. People with schizophrenia have higher prevalences of HIV infection and hepatitis, osteoporosis, altered pain sensitivity, sexual dysfunction, obstetric complications, cardiovascular diseases, overweight, diabetes, dental problems, and polydipsia than the general population. Rheumatoid arthritis and cancer may occur less frequently than in the general population. Eighty-six per cent of the studies came from industrialized countries limiting the generalizability of the findings. Conclusion: The increased frequency of physical diseases in schizophrenia might be on account of factors related to schizophrenia and its treatment, but undoubtedly also results from the unsatisfactory organization of health services, from the attitudes of medical doctors, and the social stigma ascribed to the schizophrenic patients. Summations• According to this review it has been known for decades that incidences physical diseases are frequent in schizophrenia. Nevertheless, some areas such as infectious diseases have not been sufficiently studied.• Psychiatrists are often not trained well enough in the detection and treatment of physical diseases.They must be aware of the frequent medical comorbidities and should play a more active role in their diagnosis, prevention, and treatment.• Other necessary strategies include the education of patients, general practitioners and of doctors working in other medical specialities. The access to medical care of the mentally ill also needs to be improved, among others, by reducing the stigma associated with mental disorders. Considerations• The review covered a broad area of research accordingly, focusing attention to details has not been possible.• Despite the broad search strategy, studies not covered by MEDLINE or not indexed by the MeSH term of schizophrenia could have been missed. • Due to considerable differences in the design and quality of the studies in assorted and diverse areas, quantitative approaches using meta-analysis were not possible, but should be the target of future reviews focusing.

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“…An important strategy to control TB infection is to identify high-risk groups [2]. In addition to well-known risk factors of TB, such as diabetes mellitus (DM) and human immunodeficiency virus (HIV), many studies have demonstrated an increased incidence of TB in schizophrenics [3-8]. Schizophrenia is a debilitating mental disease affecting 1% of the general population [9], and it is often accompanied by physical illnesses [4,5,10] that may increase susceptibility to TB infection.…”

Section: Introductionmentioning

confidence: 99%

Incidence and outcome of newly-diagnosed tuberculosis in schizophrenics: a 12-year, nationwide, retrospective longitudinal study

Kuo

Chen

et al. 2013

BMC Infect Dis

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BackgroundTo control tuberculosis (TB), it is critical to identify at risk populations. Schizophrenia is recognized as an important risk factor for TB. However, previous studies have been confounded by comorbidities, and reports of TB infection outcomes are rare. Therefore, the current nation-wide study aimed to compare the adjusted incidence and outcome of TB diseases in schizophrenics and the general population.MethodUsing the National Health Insurance Research Database from 1998 to 2009, this retrospective longitudinal study included 60,409 schizophrenics and general population matched for age, Charlson’s score, and comorbidities. Diagnosis of TB was based on the international classification of disease, ninth revision and use of anti-TB drugs. Unfavorable outcome for TB was defined as death, loss to follow-up, or use of anti-TB treatment for more than 9 months.ResultsThe adjusted incidence of TB in schizophrenics was significantly higher than in the general population [hazard ratio, 1.52; 95% confidence interval (CI), 1.29-1.79; p < 0.001; Kaplan-Meier log-rank test, p < 0.001]. Cox regression revealed age and male gender as risk factors for newly-diagnosed TB. The outcome of TB was comparable in schizophrenics and the general population [odds ratio (OR), 0.78; 95% CI, 0.55-1.09; p =0.144]. Logistic regression revealed a statistical trend for diabetes mellitus to predict poor outcome in schizophrenics with TB (OR, 2.30; 95% CI, 0.96-5.74; p = 0.062).ConclusionsSchizophrenics are at increased risk for TB, and screening may be warranted for those living in areas with high prevalence of TB.

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The Epidemiological Study of Physical Morbidity in Schizophrenics —2. Association between Schizophrenia and Incidence of Tuberculosis—

Cited by 14 publications

References 14 publications

Do common mental disorders decline over time in TB/HIV co-infected and HIV patients without TB who are on antiretroviral treatment?

Do common mental disorders decline over time in TB/HIV co-infected and HIV patients without TB who are on antiretroviral treatment?

Physical illness and schizophrenia: a review of the literature

Incidence and outcome of newly-diagnosed tuberculosis in schizophrenics: a 12-year, nationwide, retrospective longitudinal study

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