UTI Burden with Schizophrenia

Schizophrenia relapse linked to urinary tract troubles

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Urinary tract infections are a pretty common problem. But for people with schizophrenia, that type of infection may be even more common and may go unnoticed and untreated for a while.

In a recent study, researchers tested urine samples for signs of urinary tract infections in hospitalized schizophrenics, stable schizophrenia patients not in the hospital and a group of healthy people.

These results showed that people experiencing a schizophrenic relapse had a much higher risk of developing a urinary tract infection.

The authors said they were not sure whether anti-psychotic medication for schizophrenia could increase the risk of developing a urinary tract infection or whether the infection could increase the risk of a psychotic episode.

"See an MD immediately if you experience painful urination."

Brian J. Miller, MD, PhD, from the Department of Psychiatry and Health Behavior at the Georgia Health Sciences University, led an investigation into the risks of developing urinary tract infections in patients experiencing a schizophrenic episode.

According to the authors, previous studies have shown people with schizophrenia have a higher risk for bacterial infections compared to the general population. 

The authors said that urinary tract infection is the most common type of bacterial infection in humans, with around half of all women experiencing at least one urinary tract infection in their lifetime.

Symptoms of urinary tract infection include painful urination, difficulty urinating, blood in the urine, a burning sensation when urinating and the constant urge to urinate even when the bladder is empty.

For this small study, 136 people were recruited between 2010 and 2012 from the Georgia Health Sciences University Medical Center.

The researchers tested a urine sample from each participant for signs of possible urinary tract infection. Of the group, 57 were in the hospital for psychotic symptoms of schizophrenia, 40 were stable schizophrenia outpatients not currently experiencing symptoms and 39 were healthy controls.

Psychotic symptoms of schizophrenia include, hallucinations, delusions or false beliefs, disorganized thinking and flattened or agitated mood.

Due to the altered mental state in a schizophrenic episode, patients may not be aware of, or may be unable to properly communicate about, any physical health issues.

Usually, urinary tract infections are diagnosed when the patient complains of symptoms, and are then confirmed through a lab test of the patient's urine. This study did not take patient symptoms into account, only the lab tests. 

The results of the study showed that 35 percent of the schizophrenia patients experiencing symptoms of a schizophrenic relapse had abnormal urine tests. Only 5 percent of the stable schizophrenia outpatients and only 3 percent of the healthy controls had abnormal urine tests.

While in the hospital for schizophrenia symptoms, only 40 percent of the patients with abnormal urine tests were diagnosed and treated with the necessary antibiotics to combat a urinary tract infection. 

The researchers said that schizophrenia patients experiencing a short-term psychotic episode had 29 times the risk of developing a urinary tract infection compared to healthy controls, even after taking gender and smoking status into account.

The study was limited by its small sample size, and did not factor in any of the patients' reported urinary tract infection symptoms.

The authors recommended further investigation into why the risk for urinary tract infection was so much higher in schizophrenia patients during a psychotic episode.

This study was published in April in the Journal of Clinical Psychiatry.

Dr. Miller reported grant funding from the National Institute of Mental Health, Georgia Health Sciences University and the University of Oulu in Finland. No conflicts of interest were found.

Reviewed by: 
Review Date: 
April 3, 2013
Last Updated:
January 2, 2014