Middle-ear disease and schizophrenia: Case-control study

Cheshire & Wirral Partnership NHS Foundation Trust, The Stein Centre, St Catherine's Hospital, Birkenhead CH42 0LQ, UK.
The British Journal of Psychiatry (Impact Factor: 7.99). 10/2008; 193(3):192-6. DOI: 10.1192/bjp.bp.108.052795
Source: PubMed


One hundred years ago psychiatrists thought that ear disease could cause insanity by irritation of the brain. Current understanding of the role of the temporal lobes in schizophrenia and their proximity to the middle ear supports this hypothesis.
To establish the rate of middle-ear disease pre-dating the onset of schizophrenia.
Eighty-four patients with schizophrenia were each matched to four non-psychiatric controls by age, gender and season of birth. History of ear disease was obtained from general practice records. Additional information on symptoms was collected for participants in the case group, who also had audiometry.
The odds ratio of recorded middle-ear disease pre-dating schizophrenia was 3.68 (95% CI 1.86-7.28). This excess was particularly marked on the left (OR=4.15, 95% CI 2.08-8.29). Auditory hallucinations were associated with middle-ear disease but not with hearing loss.
There is an association between middle-ear disease and schizophrenia which may have aetiological significance.

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    • "hypoxia, hyperbilirubinaemia, very low birthweight ) (Bergman et al. 1985 ; Roizen, 2003), middle ear infections (Davidson et al. 1989) and low socioeconomic status (Chadha et al. 2006). These are all known risks for psychotic illness (Mason & Winton, 1995 ; Cannon et al. 2002b ; Wicks et al. 2005 ; Mason et al. 2008 ; Abel et al. 2010 ; Arias et al. 2012) and therefore also may act as potential confounders of any association between hearing impairment and psychosis . In a contemporaneous Swedish study of preschool children (Darin et al. 1997), the aetiology of hearing loss was reported to be 58 % prenatal causes (with heredity in 33 %), 7 % perinatal causes, 12 % postnatal causes and 23 % unknown. "
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