Center of Medical Genetics, Tzu Chi General Hospital, Hualien, Taiwan.
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
Schizophr Res. 2018 Dec;202:316-321. doi: 10.1016/j.schres.2018.06.050. Epub 2018 Jun 25.
In Taiwan, there has been a growing emphasis on physical health screening, health education and improving access to treatment in patients with schizophrenia (SCZ). However, sexual health needs, including screening and prevention of sexually transmitted infections (STI), are neglected in this population. The study aimed to investigate the association between SCZ and the subsequent incident STI and to examine potential risk factors.
Using the National Health Insurance Research Database of Taiwan, 58,948 SCZ patients and 235,784 controls matched by gender and age were enrolled between 2000 and 2010 and followed until the end of 2011. Participants who developed any STI (HIV, syphilis, genital warts, gonorrhea, chlamydial infection, and trichomoniasis) during the follow-up period were identified. Cox regression analysis was performed to examine the risk of STI between SCZ patients and controls.
SCZ patients were predisposed to developing STI (hazard ratio (HR): 1.11, 95% confidence interval (95% CI): 1.01-1.21) that could be caused by syphilis (HR: 2.58, 95% CI: 2.14-3.10) or possibly HIV (Crude HR: 1.39, 95% CI: 1.04-1.86; adjusted HR: 1.11, 95% CI: 0.81-1.52). Additionally, this study found that female, young adults, low-income, living in less urbanized areas, and comorbid substance abuse were potential risk factors for developing STI.
This study shows that SCZ is associated with an increased risk of developing STI, which has direct implications for the development of targeted prevention interventions or regular sexual health screening in mental health clinics to reduce the disproportionate burden of HIV and other STI in SCZ patients.
在台湾，人们越来越重视精神分裂症（SCZ）患者的身体健康筛查、健康教育和治疗机会的改善。然而，该人群的性健康需求，包括筛查和预防性传播感染（STI），却被忽视了。本研究旨在调查 SCZ 与随后发生的 STI 之间的关联，并探讨潜在的危险因素。
利用台湾全民健康保险研究数据库，在 2000 年至 2010 年间纳入了 58948 名 SCZ 患者和 235784 名按性别和年龄匹配的对照组，并随访至 2011 年底。在随访期间，确定参与者是否患有任何 STI（HIV、梅毒、生殖器疣、淋病、衣原体感染和滴虫病）。采用 Cox 回归分析比较 SCZ 患者与对照组发生 STI 的风险。
SCZ 患者发生 STI 的风险较高（风险比（HR）：1.11，95%置信区间（95%CI）：1.01-1.21），这可能是由梅毒（HR：2.58，95%CI：2.14-3.10）或 HIV 引起的（粗 HR：1.39，95%CI：1.04-1.86；调整 HR：1.11，95%CI：0.81-1.52）。此外，本研究还发现，女性、年轻成年人、低收入、居住在欠发达地区以及合并物质滥用是发生 STI 的潜在危险因素。
本研究表明，SCZ 与发生 STI 的风险增加有关，这对精神卫生诊所制定有针对性的预防干预措施或定期进行性健康筛查以减少 HIV 和其他 STI 在 SCZ 患者中的不成比例负担具有直接意义。
