The British Journal of Psychiatry (2008) 193: 192-196. doi: 10.1192/bjp.bp.108.052795
© 2008 The Royal College of Psychiatrists
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Middle-ear disease and schizophrenia: case–control study

Peter Mason, BMedSci, BM, BS, MRCPsych, Michael Rimmer, MB, ChB, Anna Richman, MB, ChB, Gagan Garg, MB, BS and Joe Johnson, MB, BS

North Sefton and West Lancashire NHS Trust, Ormskirk & District General Hospital, Lancashire, UK

Patricia G. Mottram, BSc, MSc, PhD

Cheshire and Wirral Partnership NHS Foundation Trust, St Catherine’s Hospital, Birkenhead, UK

Correspondence: Dr Peter Mason, Cheshire & Wirral Partnership NHS Foundation Trust, The Stein Centre, St Catherine’s Hospital, Derby Road, Birkenhead CH42 0LQ, UK. Email: peter.mason{at}cwp.nhs.uk

Declaration of interest

None.

Background

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.

Aims

To establish the rate of middle-ear disease pre-dating the onset of schizophrenia.

Method

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.

Results

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.

Conclusions

There is an association between middle-ear disease and schizophrenia which may have aetiological significance.




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Aetiological significance of middle-ear disease in schizophrenia
The British Journal of Psychiatry, January 1, 2009; 194(1): 89 - 89.
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P. R. Mason
Author's reply:
The British Journal of Psychiatry, January 1, 2009; 194(1): 89 - 90.
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eLetters:

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Middle-ear disease and Schizophrenia
Ramanathan K Ganapathy
BJP Online, 25 Oct 2008 [Full text]
Aetiological Significance of Middle ear disease in Schizophrenia
Ashok K Jainer, et al.
BJP Online, 19 Oct 2008 [Full text]
Re: Aetiological Significance of Middle ear disease in Schizophrenia
Peter R Mason
BJP Online, 25 Oct 2008 [Full text]
Re: Middle-ear disease and Schizophrenia
Peter R Mason
BJP Online, 27 Nov 2008 [Full text]
Middle Ear Disease (MED) and Schizophrenia...a differential association?
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BJP Online, 27 Nov 2008 [Full text]