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Association between schizophrenia and an autoimmune bullous skin disease-pemphigus: a population-based large-scale study

Published online by Cambridge University Press:  25 September 2017

K. Kridin ,
S. Zelber-Sagi ,
D. Comaneshter  and
A. D. Cohen
K. Kridin*
Affiliation:
Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
S. Zelber-Sagi
Affiliation:
School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
D. Comaneshter
Affiliation:
Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
A. D. Cohen
Affiliation:
Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
*
*Address for correspondence: K. Kridin, Department of Dermatology, Rambam Health Care Campus, POB 9602, Haifa 31096, Israel. (Email: dr_kridin@hotmail.com)
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Abstract

Aims.

Immunological hypotheses have become increasingly prominent suggesting that autoimmunity may be involved in the pathogenesis of schizophrenia. Schizophrenia was found to be associated with a wide range of autoimmune diseases. However, the association between pemphigus and schizophrenia has not been established yet. We aimed to estimate the association between pemphigus and schizophrenia using a large-scale real-life computerised database.

Methods.

This study was conducted as a cross-sectional study utilising the database of Clalit Health Services. The proportion of schizophrenia was compared between patients diagnosed with pemphigus and age-, gender- and ethnicity-matched control subjects. Univariate analysis was performed using χ2 and Student's t-test and a multivariate analysis was performed using a logistic regression model.

Results.

A total of 1985 pemphigus patients and 9874 controls were included in the study. The prevalence of schizophrenia was greater in patients with pemphigus as compared to the control group (2.0% v. 1.3%, respectively; p = 0.019). In a multivariate analysis, pemphigus was significantly associated with schizophrenia (OR, 1.5; 95% CI, 1.1–2.2). The association was more prominent among females, patients older than 60 years, and Jews.

Conclusions.

Pemphigus is significantly associated with schizophrenia. Physicians treating patients with pemphigus should be aware of this possible association. Patients with pemphigus should be carefully assessed for comorbid schizophrenia and be treated appropriately.

Keywords

Associationcross-sectionalimmunological hypothesispemphigusschizophrenia
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 2 , April 2019 , pp. 191 - 198
Copyright
Copyright © Cambridge University Press 2017 

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