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Sexually transmitted infections risk higher after first-episode schizophrenia in young people

Key clinical point: Adolescents and young adults with first-episode schizophrenia (FES) are highly vulnerable to contracting sexually transmitted infections (STIs), particularly, human immunodeficiency virus (HIV) and syphilis.

Major finding: Compared with control participants without schizophrenia, young participants had a higher risk of STIs (hazard ratio [HR], 2.35; 95% CI, 2.08-2.64), including HIV (HR, 3.70; 95% CI, 2.60-5.28) and syphilis (HR, 5.35; 95% CI, 3.96-7.23) after FES. The risk further increased when they presented with substance use disorder and severe schizophrenia.

Study details: Study of 44,109 adolescents and young adults with FES and 176,436 age- and sex-matched control participants without schizophrenia using Taiwan’s National Health Insurance Research Database.

Disclosures: This study was supported by a grant from the Taipei Veterans General Hospital and the Ministry of Science and Technology, Taiwan. The authors declared no conflict of interest.


Early adulthood is a time of substantial educational, social and occupational development. Unfortunately, the onset of schizophrenia often occurs in this critical developmental time-period, and perhaps not surprisingly, is associated with a host of problems for young people with early-onset schizophrenia symptoms including academic delays and interpersonal problems such as social isolation, reduced peer support and disrupted family relationships. This national cohort study from Taiwan noted that young people with first-episode schizophrenia are at high risk of sexually transmitted diseases, including syphilis and HIV. Findings underscore the importance of psychiatric medication treatment, which appears to have protective effects, and the need to address and treat substance use comorbidity as these individuals may be at particularly elevated risk.”

Martha Sajatovic, MD

Professor of Psychiatry and of Neurology

WillardBrown Chair in Neurological Outcomes Research

Director, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center

Case Western Reserve University School of Medicine


Liang CS et al. Schizophr Bull. 2020 Feb 15. doi: 10.1093/schbul/sbz126.