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Complications and mortality in patients with schizophrenia and diabetes: population-based cohort study
Chi-Shin Wu1, Mei-Shu Lai1, Susan Shur-Fen Gau2
1Chi-Shin Wu, MD, MSc, Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei and Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Mei-Shu Lai, MD, PhD, Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan; Susan Shur-Fen Gau, MD, PhD, Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei and Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
Background:
The long-term outcome of patients with both diabetes and schizophrenia remains unclear.
Aims:
To explore whether having schizophrenia increases the risk of advanced complications and mortality in people with diabetes.
Method:
This is a population-based matched cohort study using Taiwan's National Health Insurance Research Database. A total of 11 247 participants with diabetes and schizophrenia and 11 247 participants with diabetes but not schizophrenia were enrolled. We used Cox proportional hazard models to determine the effect of schizophrenia on macrovascular and microvascular complications, and all-cause mortality.
Results:
The adjusted hazard ratios were 1.49 (95% CI 1.32-1.68) for macrovascular complications, 1.05 (95% CI 0.91-1.21) for microvascular complications and 3.68 (95% CI 3.21-4.22) for all-cause mortality in patients with diabetes and schizophrenia compared with those patients with diabetes but not schizophrenia.
Conclusions:
Patients with both diabetes and schizophrenia had an increased risk of macrovascular complications and all-cause mortality but did not have statistically significant elevated risk of microvascular complications.
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