A population-based study of atopic disorders and inflammatory markers in childhood before psychotic experiences in adolescence.
Schizophrenia is associated with atopy and increased inflammatory markers. We report a population-based longitudinal study of the associations between childhood atopic disorders, subsequent serum inflammatory markers, interleukin 6 (IL-6) and C-reactive protein (CRP), and the risk of psychotic experiences (PEs).
PEs were assessed at age 13years (n=6785). Presence of clinician-diagnosed atopic disorders (asthma and eczema) was determined from parent-completed questionnaires at age 10years (n=7814).
Serum IL-6 and CRP were measured at age 9years (n=5076). Logistic regression examined the association between (1) atopy and PEs, (2) inflammatory markers and PEs, and (3) mediating effects of inflammatory markers on the atopy-PEs association.
Linear regression examined the association between atopy and inflammatory markers. Age, gender, social class, ethnicity and body mass index were included as potential confounders.
At age 10years, about 14% of the sample was reported to have asthma, 12% eczema, and 7% both asthma and eczema.
Compared with children with no atopy, risk of PEs at age 13years was increased for all of these groups; adjusted odds ratios (95% CI) were, respectively,
1.33 (1.04-1.69), and
Atopy was associated with increased serum IL-6 and CRP; however, this did not mediate association between atopy and PEs. Inflammatory markers were not associated with later PEs.
Childhood atopic disorders increase the risk of psychotic experiences in adolescence. Follow-up of these individuals will be useful to determine the effect of atopy and inflammation on different trajectories of early-life PEs.
© 2013. Published by Elsevier B.V. All rights reserved.
Further Readings of Interest
Psychiatric and general medical conditions comorbid with schizophrenia in the National Hospital Discharge Survey.
Morbidity and mortality from general medical conditions are elevated among patients with schizophrenia compared with the general U.S. population.
More than 50% of patients with schizophrenia have one or more comorbid psychiatric or general medical conditions. This study determined types of comorbid disorders and their prevalence among hospitalized patients with and without schizophrenia.
Data from the National Hospital Discharge Survey, a nationally representative sample, were analyzed for 1979-2003 (N=5,733,781 discharges).
For discharges of patients aged 15 to 64 with at least one comorbid condition, the conditions of those with a primary diagnosis of schizophrenia (N=26,279) were compared with those with other primary diagnoses (N=1,936,876). Proportional morbidity ratios (PMRs) were calculated.
The proportion of discharges listing schizophrenia, particularly schizoaffective disorder, increased significantly over time among both males and females.
The proportion was higher among males, blacks, and discharges in the Northeast.
Discharge records with a primary diagnosis of schizophrenia showed higher proportions of all comorbid psychiatric conditions examined and of some general medical conditions, including
acquired hypothyroidism (PMR=2.9),
contact dermatitis and other eczema (PMR=2.9),
viral hepatitis (PMR=1.4),
diabetes type II (PMR=1.2),
essential hypertension (PMR=1.2), and
various chronic obstructive pulmonary diseases (PMR range 1.2-1.5).