Familial Mediterranean fever association with schizophrenia: insights from big data analysis.

Introduction: Several autoimmune diseases have been associated with schizophrenia; however, little is known about putative links with auto-inflammatory conditions. We investigated the association between familial Mediterranean fever (FMF), a paradigmatic auto-inflammatory disease, and schizophrenia and assessed the impact of the latter on the survival of FMF patients. Material and methods: A case-control study was performed by utilising the database of Clalit Health Services, the largest health maintenance organisation in Israel. Familial Mediterranean fever patients were compared to age- and sex-matched controls in terms of prevalence of schizophrenia. The χ Results: The study included 7747 FMF patients and 10,080 age- and sex-matched controls (case-control match 1 : 1.3). On univariate analysis, 50 FMF patients (0.6%) and 89 controls (0.9%) had schizophrenia. On multiple logistic regression model, FMF was inversely associated with schizophrenia (OR = 0.64 [95% CI: 0.43-0.90], Conclusions: Familial Mediterranean fever patients have a significantly lower proportion of schizophrenia than controls. The current evidence shows that auto-inflammatory conditions confer protection against schizophrenia development. Patients with either FMF or schizophrenia are at higher risk of all-cause mortality, a finding that calls for assessment of better medical management of mortality outcomes.