Rheumatoid arthritis and schizophrenia: a negative association at a dimensional level

Gorwood, P.; Pouchot, J.; Vinceneux, P.; Puéchal, X.; Flipo, R.M.; De Bandt, M.; Adès, J.; Club Rhumatisme et Inflammation (CRI),

doi:10.1016/S0920-9964(03)00017-3

« Previous Next »Schizophrenia Research
Volume 66, Issue 1 , Pages 21-29, 1 January 2004

Rheumatoid arthritis and schizophrenia: a negative association at a dimensional level

P. Gorwood
- Corresponding author. Hôpital Louis Mourier, Service de Psychiatrie, 178 rue des Renouillers, 92700 Colombes, France. Tel.: +33-1-47-60-64-06; fax: +33-1-47-60-67-40.
- Hôpital Louis Mourier (AP-HP), Service de Psychiatrie, 178 rue des Renouillers, 92700 Colombes, France
- CNRS UMR 7593-Paris VII, Vulnérabilité, Adaptation et Psychopathologie, CHU Pitié-Salpêtrière, 75013 Paris, France
J. Pouchot
- Hôpital Louis Mourier (AP-HP), Service de Médecine Interne, 178 rue des Renouillers, 92700 Colombes, France
P. Vinceneux
- Hôpital Louis Mourier (AP-HP), Service de Médecine Interne, 178 rue des Renouillers, 92700 Colombes, France
X. Puéchal
- Centre Hospitalier Le Mans, 194 avenue Rubillard, 72037 Le Mans, France
R.M. Flipo
- Service de Rhumatologie, Hôpital Roger Salengro, 59037 Lille, France
M. De Bandt
- Hôpital Xavier Bichat (AP-HP), Service de Rhumatologie, 46 rue Henri Huchard, 75018, Paris, France
J. Adès
- Hôpital Louis Mourier (AP-HP), Service de Psychiatrie, 178 rue des Renouillers, 92700 Colombes, France
- CNRS UMR 7593-Paris VII, Vulnérabilité, Adaptation et Psychopathologie, CHU Pitié-Salpêtrière, 75013 Paris, France
Club Rhumatisme et Inflammation (CRI)
- Hôpital Xavier Bichat (AP-HP), Service de Rhumatologie, 46 rue Henri Huchard, 75018, Paris, France

Received 8 September 2002; accepted 20 January 2003.

Abstract

There is wide evidence for a decreased risk of rheumatoid arthritis in patients with schizophrenia. Nevertheless, very few studies have looked at the risk of schizophrenia in a group of patients with rheumatoid arthritis.

We prospectively investigated, with the SCL-90R, 220 consecutive outpatients with rheumatoid arthritis and 196 consecutive outpatients with various medical conditions, half of them suffering from psoriatic arthritis (a medical condition close to rheumatoid arthritis).

The SCL-90R appears to be a valuable tool to distinguish patients with schizophrenia from the outpatients of our sample, the former having more “paranoid ideation” (p=0.004) and more “psychoticism” (p<0.001) than the latter. The “paranoid ideation” dimension was significantly lower (25% decrease) in the sample of patients with rheumatoid arthritis compared to the combined control group (p=0.005), ratings under the median value being more frequent in the former group (p=0.025). Confounding factors might not explain this difference according to the regression logistic analysis performed.

As patients with rheumatoid arthritis have a lower score of paranoid ideation than controls in our sample, even after controlling for age, gender and severity of the disease, these data represent further evidence for a decreased risk of schizophrenia in individuals with rheumatoid arthritis.

Keywords: Rheumatoid arthritis, Schizophrenia, SCL-90R, Psychoticism, Inflammatory, Genetics