Schizophrenia linked to increased risk for upper GI bleeding, ulcers

  • Cotton CC & al.
  • Clin Transl Gastroenterol
  • 1 Feb 2019

  • International Clinical Digest
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Takeaway

  • People with schizophrenia have increased risk for upper gastrointestinal bleeding (UGIB) and nonbleeding ulcers despite not having risk factors different from the general population.
  • In these patients, having these conditions is tied to increased all-cause mortality.
  • This cohort study involves 32 years of follow-up.

Why this matters

  • These authors say that an elevated risk for UGIB, ulcers might be expected because of increased rates of substance abuse among people with schizophrenia.

Key results

  • There were 459,564 person-years of follow-up. 
  • With schizophrenia, standardized incidence ratios (95% CIs) were:
    • 2.92 (2.76-3.08) for UGIB;
    • 2.36 (2.15-2.58) for bleeding ulcers; and
    • 2.00 (1.87-2.15) for nonbleeding ulcers.
  • No difference by sex seen, values were largely stable across age, year of diagnosis.
  • Age of diagnosis >35 years was a risk factor for UGIB: adjusted HR, 2.32 (95% CI, 1.75-3.08).
  • These patients were also likelier to have bleeding ulcers: adjusted HR, 8.50 (95% CI, 3.76-19.17).

Study design

  • Danish registry data, patients with incident schizophrenia, 1980-2011.
  • Outcomes: cumulative incidences, risk factors, all-cause mortality.
  • Funding: RocheProd, Ltd., Welwyn Garden City, United Kingdom, others.

Limitations

  • Generalizability to other national health care settings unclear.
  • Patients with schizophrenia in Denmark might be healthier than those in nations without universal health care.

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