A prevalence study of urinary tract infections in acute relapse of schizophrenia

Brian J Miller, Krystle Leigh Graham, Chelsea Mary Carson, Nick H. Culpepper, Jennifer L Waller, Peter F Buckley

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective: Schizophrenia is associated with immune abnormalities and increased mortality from infectious diseases. The aim of this study was to examine whether acute relapse of schizophrenia was associated with urinary tract infection (UTI), in comparison with controls, after controlling for potential confounding factors. Method: In a prevalence study conducted from January 2010 to April 2012 at Georgia Health Sciences University Medical Center, Augusta, we recruited 136 adult subjects (mean age = 42.8 years): 57 inpatients with an acute relapse of DSM-IV schizophrenia, 40 stable outpatients with DSM-IV schizophrenia, and 39 healthy controls from the community. Urinary tract infection was defined as having positive leukocyte esterase and/ or positive nitrites on urinalysis and having ≥ 5 leukocytes per high-powered field (implies 5-10 or more) on urine microscopy. Determination of UTI status was made for each subject, and analyses were performed to examine the association between UTI and acute relapse of schizophrenia. Results: 35% of acutely relapsed subjects, versus 5% of stable outpatients and 3% of controls, had a UTI (P < .001). Only 40% of subjects in the acute relapse group classified as having a UTI were treated with antibiotics during hospitalization. After analyses were controlled for gender and smoking status, subjects in the acute relapse group were almost 29 times more likely to have a UTI than controls (odds ratio = 28.97; 95% CI, 3.44-243.85; P = .002). There was no statistically significant association with UTI among the stable outpatients versus controls. Conclusions: Our finding of an association between an increased prevalence of UTI and acute psychotic relapse warrants replication in other samples. The mechanism of this association remains unclear. The results also highlight the potential importance of monitoring for comorbid UTI in acutely relapsed patients with schizophrenia.

Original languageEnglish (US)
Pages (from-to)271-277
Number of pages7
JournalJournal of Clinical Psychiatry
Volume74
Issue number3
DOIs
StatePublished - Jan 1 2013

Fingerprint

Urinary Tract Infections
Schizophrenia
Cross-Sectional Studies
Recurrence
Outpatients
Diagnostic and Statistical Manual of Mental Disorders
Urinalysis
Infection Control
Nitrites
Communicable Diseases
Inpatients
Microscopy
Hospitalization
Leukocytes
Smoking
Odds Ratio
Urine
Anti-Bacterial Agents
Mortality
Health

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

A prevalence study of urinary tract infections in acute relapse of schizophrenia. / Miller, Brian J; Graham, Krystle Leigh; Carson, Chelsea Mary; Culpepper, Nick H.; Waller, Jennifer L; Buckley, Peter F.

In: Journal of Clinical Psychiatry, Vol. 74, No. 3, 01.01.2013, p. 271-277.

Research output: Contribution to journalArticle

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