Schizophrenia and risk of new-onset inflammatory bowel disease: a nationwide longitudinal study

Kuan Yi Sung, Bing Zhang, Hohui E. Wang, Ya Mei Bai, Shih Jen Tsai, Tung Ping Su, Tzeng Ji Chen, Ming Chih Hou, Ching Liang Lu, Yen Po Wang*, Mu Hong Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background and Aims: Inflammatory bowel disease (IBD) is a chronic gastrointestinal inflammatory disorder with increasing global prevalence. The risk of IBD in patients with schizophrenia remains unclear. We aim to investigate the risk of new-onset IBD in patients with schizophrenia compared with matched controls. Methods: We conducted a retrospective, population-based cohort study utilising patient data from the Taiwan National Health Insurance Research Database collected between January 1, 2001, and December 31, 2011. Patients diagnosed with schizophrenia by board-certified psychiatrists without prior diagnosis of IBD were enrolled and matched to controls in 1:4 fashion by age, sex, residence, income level and medical comorbidities. Adjusted hazard ratios (HRs) for new-onset IBD and sub-analyses were determined using Cox regression analysis with adjustments. Results: Among 116 164 patients with schizophrenia and 464 656 matched controls, overall incidence of IBD among patients was significantly higher (1.14% vs. 0.25%). Average age of IBD diagnosis was 46.82 among patients with schizophrenia, versus 55.30 among controls. The HR of developing IBD among patients was 3.28, with a 95% confidence interval (95% CI) 2.49–4.33. IBD risk was higher among patients with psychiatric admissions more than once per year (HR 7.99, 95% CI 5.25–12.15) compared to those hospitalised less frequently (HR 2.72, 95% CI 2.03–3.66). Conclusions: This population-based cohort study demonstrates a significant association between schizophrenia and subsequent IBD development. Patients with schizophrenia develop IBD at a younger age, and the risk increases with inadequately controlled schizophrenia. Physician vigilance and awareness of this correlation will improve IBD diagnosis and management among this vulnerable patient population.

Original languageEnglish
JournalAlimentary Pharmacology and Therapeutics
StateAccepted/In press - 2022


  • cohort studies
  • gastrointestinal microbiome
  • inflammatory bowel disease
  • schizophrenia


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