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Acta Psychiatr Scand. 2017 Nov;136(5):445-454. doi: 10.1111/acps.12776. Epub 2017 Jul 25.

The association between season of birth, age at onset, and clozapine use in schizophrenia.

Author information

1
Clinical Emotion and Cognition Research Laboratory, Goyang, Korea.
2
Department of Psychiatry, Soonchunhyang University of College of Medicine, Cheonan, Korea.
3
National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
4
Pharmaceutical Policy & Outcomes Research, School of Pharmacy, Sungkyunkwan University, Sowon, Korea.
5
Gong-ju National Hospital, Gongju, Korea.
6
Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, Korea.
7
Department of Psychiatry, Chonbuk National University Hospital, Jeonju, Korea.
8
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
9
Department of Psychiatry, Hallym University Chuncheon Sacred Hospital, College of Medicine, Hallym University, Chuncheon, Korea.
10
Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, Korea.
11
Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea.

Abstract

OBJECTIVE:

This study aimed to determine whether the rate of clozapine use, an indicator of refractoriness in schizophrenia, is associated with the season of birth and age at onset in patients with schizophrenia based on nationwide data.

METHODS:

Patients with schizophrenia (n = 114 749) who received prescriptions for antipsychotic medication between 2008 and 2014 were retrospectively identified from the Korean National Health Insurance Service database. The study population was divided into three groups based on their age at the onset of schizophrenia (early, middle, and late onset). We assessed differences in the month of birth between patients and the general population. In addition, the cumulative clozapine use was calculated.

RESULTS:

Compared to the late-onset schizophrenia group, the early- and middle-onset groups showed a higher probability of birth during the winter season. In addition, the early-onset group showed the highest cumulative clozapine use rate. In the middle-onset group, the initiation of clozapine use was significantly earlier for patients born in winter compared to those born in summer.

CONCLUSION:

Our results indicate that the age at onset is an important factor in predicting the prognosis of schizophrenia patients. The season of birth also affects the prognosis, but with less robustness. Specifically, it appears that early disease onset and winter birth might be associated with poor outcomes in Korean patients with schizophrenia.

KEYWORDS:

age at onset; clozapine use rate; prognosis; schizophrenia; seasonal birth

PMID:
28741647
DOI:
10.1111/acps.12776
[Indexed for MEDLINE]

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