The association of peptic ulcer and schizophrenia: A population-based study

Liao, Chien-Chang; Chang, Chen-Shu; Chang, Shang‐Tzen; Muo, Chih‐Hsin; Lane, Hsien‐Yuan; Sung, Fung‐Chang; Kao, Chia‐Hung

doi:10.1016/j.jpsychores.2014.08.005

Cited by 17 publications

(9 citation statements)

References 35 publications

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“…The incidence in our study was similar to those of several former reports in Taiwan with incidence of 9.52% per 1000 person-years in a 2001–2009 cohort study based on LHID 2000 and prevalence of 9.4% in a cross-sectional study of individuals for self-paid physical check-up conducted in 2008 [19, 20]. In 1 million people, 297054 patients received a diagnosis of PUD; therefore, the prevalence was approximately 29.7% in our study.…”

Section: Discussionsupporting

confidence: 91%

The Development of Diabetes after Subtotal Gastrectomy with Billroth II Anastomosis for Peptic Ulcer Disease

et al. 2016

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PurposeA duodenal bypass after a Roux-en-Y gastric bypass operation for obesity can ameliorate the development of diabetes mellitus (DM). We attempted to determine the subsequent risk of developing DM after subtotal gastrectomy with Billroth II anastomosis (SGBIIA) for peptic ulcer disease (PUD).MethodsWe identified 662 patients undergoing SGBIIA for PUD between 2000 and 2011 from the Longitudinal Health Insurance Database as the study cohort, and we randomly selected 2647 controls from the peptic ulcer population not undergoing SGBIIA and were frequency-matched by age, sex, and index year for the control cohort. All patient cases in both cohorts were followed until the end of 2011 to measure the incidence of DM. We analyzed DM risk by using a Cox proportional hazards regression model.ResultsThe patients who underwent SGBIIA demonstrated a lower cumulative incidence of DM compared with the control cohort (log-rank test, P < .001 and 6.73 vs 12.6 per 1000 person-y). The difference in the DM risk between patients with and without SGBIIA increased gradually with the follow-up duration. Age and sex did not affect the subsequent risk of developing DM, according to the multivariable Cox regression model. Nevertheless, the SGBIIA cohort exhibited a lower DM risk after we adjusted for the comorbidities of hypertension, hyperlipidemia, and coronary artery disease (adjusted hazard ratio (aHR): 0.56, 95% confidence interval (CI): 0.40–0.78). The incidence rate ratio (IRR) of DM in the SGBIIA cohort was lower than that in the control cohort for all age groups (age ≤ 49 y, IRR: 0.40, 95% CI: 0.16–0.99; age 50–64 y, IRR: 0.54, 95% CI: 0.31–0.96; age ≧ 65 y, IRR: 0.57, 95% CI: 0.36–0.91). Moreover, the IRR of DM was significantly lower in the SGBIIA cohort with comorbidities (IRR: 0.50, 95% CI: 0.31–0.78) compared with those without a comorbidity (IRR: 0.65, 95% CI: 0.40–1.04).ConclusionThe findings of this population-based cohort study revealed that SGBIIA was associated with a reduced risk of DM development, and the inverse association was greater in the presence of a comorbidity.

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Section: Discussionsupporting

confidence: 91%

The Development of Diabetes after Subtotal Gastrectomy with Billroth II Anastomosis for Peptic Ulcer Disease

et al. 2016

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“…The association between schizophrenia and ulcers, seen in our study, has not been shown by all available evidence. In cohort study based on insurance claims in Taiwan, schizophrenia was associated with a 27-percent higher risk of peptic ulcer compared with the general population after adjustment, but the association was no longer present after controlling for use of medications, including analgesics and nervous system medications (8). A hospital-based case-control study in the United States comparing the cases of schizophrenia with controls on the prevalence of peptic ulcers reported an inverse association between schizophrenia and peptic ulcer, although, by design, the study estimated the risk of schizophrenia in patients with vs without ulcers, not vice versa (9).…”

Section: Discussionmentioning

confidence: 99%

“…A hospital-based case-control study in the United States comparing the cases of schizophrenia with controls on the prevalence of peptic ulcers reported an inverse association between schizophrenia and peptic ulcer, although, by design, the study estimated the risk of schizophrenia in patients with vs without ulcers, not vice versa (9). The differences in observations may stem from greater risks of the outcomes in the comparator groups of the 2 studies (contributors of insurance claims (8) and hospitalized patients (8), respectively). In our analysis, the association did not change after inclusion, from 1995 onward, of the diagnoses recorded at hospital outpatient clinics, in addition to the diagnoses recorded at hospitalizations.…”

Section: Discussionmentioning

confidence: 99%

Risk of Upper Gastrointestinal Bleeding and Gastroduodenal Ulcers in Persons With Schizophrenia: A Danish Cohort Study

Cotton

Farkas

Foskett

et al. 2019

Clin Transl Gastroenterol

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INTRODUCTION: There is little evidence about gastrointestinal (GI) disorders in patients with schizophrenia. We examined association of schizophrenia with upper GI bleeding (UGIB) and nonbleeding ulcers and associated risk factors and mortality. METHODS: We used the data linked from population-based registries in Denmark. Among patients with incident schizophrenia in 1980–2011, we computed cumulative incidences and standardized incidence ratios of UGIB, bleeding ulcers, and nonbleeding ulcers compared with the general population; evaluated risk factors for the 3 GI endpoints, including somatic and psychiatric comorbidity; and examined subsequent all-cause mortality. RESULTS: Among 39,998 patients with schizophrenia, the standardized incidence ratios were 2.92 (95% confidence interval (CI), 2.76–3.08) for UGIB, 2.36 (95% CI, 2.15–2.58) for bleeding ulcers, and 2.00 (95% CI, 1.87–2.15) for nonbleeding ulcers. Risk factors for UGIB and nonbleeding ulcers included age, somatic comorbidity, and medication use. UGIB and nonbleeding ulcers were associated with the subsequent increase in mortality. CONCLUSIONS: Schizophrenia is associated with an increased risk of UGIB and nonbleeding ulcers, whose risk factors in patients with schizophrenia are similar to those in the general population.

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“… 7 Evidence has shown that both physical stress and psychological stress are closely related to PUD. 8 , 9 Notably, PUD risk among schizophrenia or anxiety disorder patients has been documented, 10 , 11 but not for depression patients. To make the diagnosis of unipolar depression, patient should not have mania or hypomania, or their diagnosis should be bipolar disorders (BD) instead.…”

Section: Introductionmentioning

confidence: 99%

Depression and the Risk of Peptic Ulcer Disease

Hsu

Chang

et al. 2015

Medicine

Self Cite

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The risk of peptic ulcer disease (PUD) among patients with depression has raised concern. This study determined the association between depression and the subsequent development of PUD using claims data.Patients newly diagnosed with depression in 2000 to 2010 were identified as depression cohort from the Taiwan National Health Insurance Research Database. The comparison cohort was randomly selected from subjects without depression, frequency matched by age and gender and diagnosis date, with a size 2-fold of the size of the depression cohort. The incidence of PUD was evaluated for both cohorts by the end of 2011. We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) of PUD using the Cox proportional hazards regression model.The depression cohort consisted of 23,536 subjects (129,751 person-years), and the comparison cohort consisted of 47,069 subjects (285,592 person-years). The incidence of PUD was 2-fold higher in the depression cohort than in the comparison cohort (33.2 vs 16.8 per 1000 person-years) with an age adjusted HR of 1.97 (95% CI = 1.89–2.06) or a multivariable adjusted HR of 1.35 (95% CI = 1.29–1.42).Depression might increase the risk of developing PUD. Prospective clinical studies of the relationship between depression and PUD are warranted.

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The association of peptic ulcer and schizophrenia: A population-based study

Cited by 17 publications

References 35 publications

The Development of Diabetes after Subtotal Gastrectomy with Billroth II Anastomosis for Peptic Ulcer Disease

The Development of Diabetes after Subtotal Gastrectomy with Billroth II Anastomosis for Peptic Ulcer Disease

Risk of Upper Gastrointestinal Bleeding and Gastroduodenal Ulcers in Persons With Schizophrenia: A Danish Cohort Study

Depression and the Risk of Peptic Ulcer Disease

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