Karine Goueslard1, Jean-Michel Petit2,3, Jonathan Cottenet1,4, Jean-Christophe Chauvet-Gelinier5,6, Fabrice Jollant7,8,9, Catherine Quantin1,4,10. 1. Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comté University, Dijon, France. 2. Centre de Recherche INSERM Unité 866, Université de Bourgogne-Franche-Comté, Dijon, France jean-michel.petit@chu-dijon.fr. 3. Services de Diabétologie et Endocrinologie, CHRU Dijon, Dijon, France. 4. INSERM, CIC 1432, and Clinical Epidemiology/Clinical Trials Unit, Clinical Investigation Center, Dijon University Hospital, Dijon, France. 5. Service de Psychiatrie et d'Addictologie, Centre Hospitalier Universitaire, Dijon, France. 6. Laboratoire de Psychopathologie et Psychologie Médicale, EA 4452, IFR Santé STIC 100, Université de Bourgogne-Franche-Comté, Dijon, France. 7. Faculté de Médicine, Université Paris-Descartes, Paris, France. 8. Centre Hospitalier Sainte-Anne, Paris, France. 9. McGill Group for Suicide Studies, McGill University and Douglas Mental Health University Institute, Montréal, Québec, Canada. 10. Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases, INSERM, Université de Versailles Saint-Quentin-en-Yvelines, Institut Pasteur, Université Paris-Saclay, Paris, France.
Abstract
OBJECTIVE: The aim of this large retrospective cohort study was to estimate the supplementary morbidity and mortality risks conferred by the co-occurrence of schizophrenia among young people with type 1 diabetes. RESEARCH DESIGN AND METHODS: This nationwide population-based study included individuals aged 15-35 years hospitalized in France for type 1 diabetes from 2009 to 2012 with or without schizophrenia. For assessment of the occurrence of rehospitalization for acute diabetes complications, suicide attempts, and hospital mortality, multivariate logistic regressions and survival analysis adjusted for age, sex, and Charlson comorbidity index scores were performed. The association between hospitalization for suicide attempts and acute diabetes complications was further explored in a survival analysis, with the exposure of acute diabetes complications as a time-dependent covariate. RESULTS: Among 45,655 individuals aged 15-35 years who were hospitalized for type 1 diabetes, 341 (0.75%) had a previous or contemporary hospitalization for schizophrenia. Within 3 years of follow-up, schizophrenia was associated with increased risks of rehospitalization for hypoglycemia (adjusted odds ratio 3.21 [95% CI 1.99-5.20]), hyperglycemia (7.01 [3.53-13.90]), ketoacidosis (2.01 [1.49-2.70]), and coma (3.17 [1.90-5.27]); hospitalization for suicide attempts (12.15 [8.49-17.38]); and hospital mortality (2.83 [1.50-5.36]). Hospitalization for a suicide attempt was associated with an increased risk of hospitalization for acute diabetes complications independently from schizophrenia (hazard ratio 3.46 [95% CI 2.74-4.38]). CONCLUSIONS: Patients suffering from the combination of type 1 diabetes and schizophrenia are at increased risk of hospitalization for acute diabetes complications as well as suicide and hospital mortality. These individuals may require specific care programs and close monitoring of mental, somatic, and social health.
OBJECTIVE: The aim of this large retrospective cohort study was to estimate the supplementary morbidity and mortality risks conferred by the co-occurrence of schizophrenia among young people with type 1 diabetes. RESEARCH DESIGN AND METHODS: This nationwide population-based study included individuals aged 15-35 years hospitalized in France for type 1 diabetes from 2009 to 2012 with or without schizophrenia. For assessment of the occurrence of rehospitalization for acute diabetes complications, suicide attempts, and hospital mortality, multivariate logistic regressions and survival analysis adjusted for age, sex, and Charlson comorbidity index scores were performed. The association between hospitalization for suicide attempts and acute diabetes complications was further explored in a survival analysis, with the exposure of acute diabetes complications as a time-dependent covariate. RESULTS: Among 45,655 individuals aged 15-35 years who were hospitalized for type 1 diabetes, 341 (0.75%) had a previous or contemporary hospitalization for schizophrenia. Within 3 years of follow-up, schizophrenia was associated with increased risks of rehospitalization for hypoglycemia (adjusted odds ratio 3.21 [95% CI 1.99-5.20]), hyperglycemia (7.01 [3.53-13.90]), ketoacidosis (2.01 [1.49-2.70]), and coma (3.17 [1.90-5.27]); hospitalization for suicide attempts (12.15 [8.49-17.38]); and hospital mortality (2.83 [1.50-5.36]). Hospitalization for a suicide attempt was associated with an increased risk of hospitalization for acute diabetes complications independently from schizophrenia (hazard ratio 3.46 [95% CI 2.74-4.38]). CONCLUSIONS:Patients suffering from the combination of type 1 diabetes and schizophrenia are at increased risk of hospitalization for acute diabetes complications as well as suicide and hospital mortality. These individuals may require specific care programs and close monitoring of mental, somatic, and social health.
Authors: Naomi Launders; Kate Dotsikas; Louise Marston; Gabriele Price; David P J Osborn; Joseph F Hayes Journal: PLoS One Date: 2022-08-18 Impact factor: 3.752