Risk of Schizophrenia After a Diagnosis of Epilepsy

Introduction: Epilepsy is associated with increased schizophrenia risk, but few large studies account for key factors. This study analyzed cohort data from Korea to assess schizophrenia risk postepilepsy diagnosis. Methods: Epilepsy patients were age-matched and sex-matched with controls. Schizophrenia was the primary outcome. Cox regression estimated adjusted hazard ratios (HRs), accounting for demographics and lifestyle factors (smoking, BMI, cholesterol, and income). Kaplan–Meier curves and log-rank tests assessed cumulative schizophrenia incidence. Results: The study included 2,770 epilepsy patients and 27,700 matched controls. The overall adjusted HR for schizophrenia among epilepsy patients was 9.44 (95% CI, 6.72–13.25). Subgroup analysis indicated the highest HR in men under 60 years at 13.44 (95% CI, 5.53–32.66), and in women aged 60 and older at 13.16 (95% CI, 7.09–24.44). Conclusions: Epilepsy increases the risk of schizophrenia, especially in younger men and older women, highlighting the need for targeted mental health monitoring and early intervention.