Schizophrenia and risk of new-onset inflammatory bowel disease: A nationwide longitudinal study
Abstract
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.
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A population-based cohort study conducted in Taiwan (2020) demonstrated a significant association between schizophrenia and subsequent IBD development (1.14% vs. 0.25% in non-IBD population).
“a population-based cohort study conducted in Taiwan (2020) demonstrated a significant association between schizophrenia and subsequent IBD development (1.14% vs. 0.25% in non-IBD population)”
From Association between Childhood Onset Inflammatory Bowel Disease and Psychiatric Comorbidities in Adulthood (2023) · cites this paper as [112]
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Tesfaye, M., Jaholkowski, P. P., Hindley, G., Shadrin, A. A., Rahman, Z., Bahrami, S., Lin, A., Holen, B., Parker, N., Cheng, W., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23819884
Tesfaye, M., Jaholkowski, P. P., Hindley, G., Shadrin, A. A., Rahman, Z., Bahrami, S., Lin, A., Holen, B., Parker, N., Cheng, W., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23819890
Tesfaye, M., Jaholkowski, P. P., Hindley, G., Shadrin, A. A., Rahman, Z., Bahrami, S., Lin, A., Holen, B., Parker, N., Cheng, W., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23819893
A multilevel study on the genetic relationship between schizophrenia and inflammatory bowel disease
Li, C., Xu, X., Luo, Q., Yang, J., Shen, P., Yuan, X., Zhang, X., & Zhang, L. (2025) · Human Immunology · doi:10.1016/j.humimm.2025.111330
Tesfaye, M., Jaholkowski, P., Hindley, G., Shadrin, A. A., Rahman, Z., Bahrami, S., Lin, A., Holen, B., Parker, N., Cheng, W., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23819881
Yao, G., Zou, T., Luo, J., Hu, S., Yang, L., Li, J., Li, X., Zhang, Y., Feng, K., Xu, Y., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26649477
Yao, G., Zou, T., Luo, J., Hu, S., Yang, L., Li, J., Li, X., Zhang, Y., Feng, K., Xu, Y., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26649474
Tesfaye, M., Jaholkowski, P., Hindley, G., Shadrin, A. A., Rahman, Z., Bahrami, S., Lin, A., Holen, B., Parker, N., Cheng, W., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23819878
Tesfaye, M., Jaholkowski, P., Hindley, G., Shadrin, A. A., Rahman, Z., Bahrami, S., Lin, A., Holen, B., Parker, N., Cheng, W., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23819887
Causal effects of inflammatory bowel disease on brain structure: A Mendelian randomization study
He, Y., He, J., & Chen, C. (2026) · Medicine · doi:10.1097/md.0000000000046867
“[23] Clarifying the pathogenic underpinning of neuropsychiatric disorders is of great clinical significance for the management of IBD patients.”
Schizophrenia as a Disorder of Biological Barriers: A Narrative Review and Potential Interventions
Sfera, A., Jafri, N., Anton, J., Turturica, D., Turturica, E., Bozza, B., & Ciuperca, I. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27041811
“In addition, inflammatory bowel disease (IBD) (a condition marked by high microbial migration outside the gastrointestinal (GI) tract) is often comorbid with SCZ, linking bacterial molecules, such as lipopolysaccharide (LPS), to this disorder [6–9].”
A SCHIZOPHRENIA HYPOTHESIS BASED ON MICROBIAL TRANSLOCATION AND ABERRANT MICROGLIAL ACTIVATION
Sfera, A., Jafri, N., Anton, J., Turturica, D., Turturica, E., Bozza, B., & Ciuperca, I. (2026) · Central Asian Journal of Medical Hypotheses and Ethics · doi:10.47316/cajmhe.2026.7.1.02
The exposome and inflammatory bowel disease: a framework for primary and primordial prevention
Agrawal, M., Midya, V., Vianello, A., Valvi, D., Kaplan, G. G., & Colombel, J. (2026) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-026-01260-2
- Authors
- Sung, K., Zhang, B., Wang, H. E., Bai, Y., Tsai, S., Su, T., Chen, T., Hou, M., Lu, C., Wang, Y., & Chen, M.
- Affiliations
- National Yang Ming Chiao Tung University (TW)
- University of Southern California (US)
- University of California, San Francisco (US)
- Corresponding author
- Wang, Yen‐Po
- Chen, Mu‐Hong
- ORCID
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2022-03-08
- Volume
- 55
- Issue
- 9
- Pages
- 1192-1201
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- OpenAlex
- W4220845423
- Cited by
- 38
- References
- 59
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 9 · 2023: 15 · 2022: 1
- FWCI
- 5.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Science and Technology, Taiwan (107‐2314‐B‐075‐063‐MY3, 108‐2314‐B‐075 ‐037)
- Taipei Veterans General Hospital (V106B‐020, V107B‐010, V107C‐181, V108B‐012, V110B‐013)
- Yen Tjing Ling Medical Foundation (CI‐109‐21, CI‐109‐22)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- schizophrenia, inflammatory bowel disease, IBD risk, psychiatric comorbidity, psychiatric hospitalization, IBD incidence
- MeSH terms
- Chronic Disease, Humans, Longitudinal Studies, Retrospective Studies, Risk Factors, Schizophrenia, Inflammatory Bowel Diseases, Cohort Studies, Incidence
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