Risk of Major Mental Disorder after Severe Bacterial Infections in Children and Adolescents: A Nationwide Longitudinal Study.

IF 2.3 4区心理学 Q3 NEUROSCIENCES

Neuropsychobiology Pub Date : 2022-01-01 DOI:10.1159/000526984

Tien-Wei Hsu, Che-Sheng Chu, Shih-Jen Tsai, Ya-Mei Bai, Tung-Ping Su, Tzeng-Ji Chen, Mu-Hong Chen, Chih-Sung Liang

{"title":"Risk of Major Mental Disorder after Severe Bacterial Infections in Children and Adolescents: A Nationwide Longitudinal Study.","authors":"Tien-Wei Hsu, Che-Sheng Chu, Shih-Jen Tsai, Ya-Mei Bai, Tung-Ping Su, Tzeng-Ji Chen, Mu-Hong Chen, Chih-Sung Liang","doi":"10.1159/000526984","DOIUrl":null,"url":null,"abstract":"Introduction: Evidence has suggested an association between bacterial infection and increased risk of subsequent major mental disorders (MMDs). Whether such association varies with different pathogens remains unclear. We aimed to investigate the risk of subsequent MMDs after exposure to bacterial pathogens in children and adolescents.Methods: Between 1997 and 2012, we enrolled a nationwide cohort of 14,024 children and adolescents with hospitalized bacterial infection, and noninfected controls were 1:4 matched for demographics. There were 11 investigated pathogens, namely, Streptococcus, Staphylococcus, Pseudomonas, Klebsiella, Hemophilus, Mycoplasma, Tuberculosis, Meningococcus, Escherichia, Chlamydia, and Scrub typhus. The primary outcomes were the subsequent risk of seven MMDs, namely, autism spectrum disorder (ASD), attention-deficiency hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), tic disorder, schizophrenia, bipolar disorder, and depressive disorder. The secondary outcomes were the subsequent risk of exposure to psychotropic medications.Results: Pooled bacterial infection was associated with increased risk of the six MMDs - ASD (reported as hazard ratios with 95% confidence intervals: 13.80; 7.40-25.75), ADHD (6.93; 5.98-8.03), OCD (3.93; 1.76-8.76), tic disorder (6.19; 4.44-8.64), bipolar disorder (2.50; 1.28-4.86), and depressive disorder (1.93; 1.48-2.51) - and exposure to four psychotropic medications, including ADHD drugs (11.81; 9.72-14.35), antidepressants (2.96; 2.45-3.57), mood stabilizers (4.51; 2.83-7.19), and atypical antipsychotics (4.23; 3.00-5.96) compared to controls. The associations among MMDs and specific pathogens varied. Importantly, Streptococcus was associated with the most MMDs (six MMDs), and ADHD was associated with eight bacterial pathogen infections.Conclusions: After bacterial infection, the risk of MMDs increased in children and adolescents compared to controls, and such associations varied with different pathogens. Future studies are warranted to validate our study findings and investigate the potential mechanisms.","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuropsychobiology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1159/000526984","RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 3

Abstract

Introduction: Evidence has suggested an association between bacterial infection and increased risk of subsequent major mental disorders (MMDs). Whether such association varies with different pathogens remains unclear. We aimed to investigate the risk of subsequent MMDs after exposure to bacterial pathogens in children and adolescents.

Methods: Between 1997 and 2012, we enrolled a nationwide cohort of 14,024 children and adolescents with hospitalized bacterial infection, and noninfected controls were 1:4 matched for demographics. There were 11 investigated pathogens, namely, Streptococcus, Staphylococcus, Pseudomonas, Klebsiella, Hemophilus, Mycoplasma, Tuberculosis, Meningococcus, Escherichia, Chlamydia, and Scrub typhus. The primary outcomes were the subsequent risk of seven MMDs, namely, autism spectrum disorder (ASD), attention-deficiency hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), tic disorder, schizophrenia, bipolar disorder, and depressive disorder. The secondary outcomes were the subsequent risk of exposure to psychotropic medications.

Results: Pooled bacterial infection was associated with increased risk of the six MMDs - ASD (reported as hazard ratios with 95% confidence intervals: 13.80; 7.40-25.75), ADHD (6.93; 5.98-8.03), OCD (3.93; 1.76-8.76), tic disorder (6.19; 4.44-8.64), bipolar disorder (2.50; 1.28-4.86), and depressive disorder (1.93; 1.48-2.51) - and exposure to four psychotropic medications, including ADHD drugs (11.81; 9.72-14.35), antidepressants (2.96; 2.45-3.57), mood stabilizers (4.51; 2.83-7.19), and atypical antipsychotics (4.23; 3.00-5.96) compared to controls. The associations among MMDs and specific pathogens varied. Importantly, Streptococcus was associated with the most MMDs (six MMDs), and ADHD was associated with eight bacterial pathogen infections.

Conclusions: After bacterial infection, the risk of MMDs increased in children and adolescents compared to controls, and such associations varied with different pathogens. Future studies are warranted to validate our study findings and investigate the potential mechanisms.

查看原文本刊更多论文

儿童和青少年严重细菌感染后严重精神障碍的风险:一项全国性的纵向研究。

有证据表明，细菌感染与随后的重大精神障碍(MMDs)风险增加之间存在关联。这种关联是否因不同的病原体而异尚不清楚。我们的目的是调查儿童和青少年暴露于细菌性病原体后发生烟雾病的风险。方法:在1997年至2012年期间，我们在全国范围内招募了14024名住院细菌感染的儿童和青少年，人口统计学上未感染的对照组为1:4匹配。调查病原菌有链球菌、葡萄球菌、假单胞菌、克雷伯氏菌、血友病、支原体、结核病、脑膜炎球菌、埃希菌、衣原体、恙虫病等11种。主要结局是7种MMDs的后续风险，即自闭症谱系障碍(ASD)、注意力缺陷多动障碍(ADHD)、强迫症(OCD)、抽动障碍、精神分裂症、双相情感障碍和抑郁症。次要结果是随后暴露于精神药物的风险。结果:合并细菌感染与6种MMDs - ASD的风险增加相关(报告的风险比为95%可信区间:13.80;7.40-25.75)， adhd (6.93;5.98-8.03)， ocd (3.93;1.76-8.76)，抽动障碍(6.19;4.44-8.64)，双相情感障碍(2.50;1.28-4.86)，抑郁障碍(1.93;1.48-2.51)——以及接触四种精神药物，包括多动症药物(11.81;9.72-14.35)，抗抑郁药(2.96;2.45-3.57)，情绪稳定剂(4.51;2.83-7.19)，非典型抗精神病药物(4.23;3.00-5.96)。MMDs与特定病原体之间的关系各不相同。重要的是，链球菌与大多数MMDs(6种MMDs)相关，而ADHD与8种细菌病原体感染相关。结论:与对照组相比，细菌感染后，儿童和青少年患烟雾病的风险增加，这种关联因病原体的不同而不同。未来的研究有必要验证我们的研究结果并调查潜在的机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Neuropsychobiology 医学-精神病学

CiteScore

7.20

自引率

0.00%

发文量

审稿时长

6 months

期刊介绍： The biological approach to mental disorders continues to yield innovative findings of clinical importance, particularly if methodologies are combined. This journal collects high quality empirical studies from various experimental and clinical approaches in the fields of Biological Psychiatry, Biological Psychology and Neuropsychology. It features original, clinical and basic research in the fields of neurophysiology and functional imaging, neuropharmacology and neurochemistry, neuroendocrinology and neuroimmunology, genetics and their relationships with normal psychology and psychopathology. In addition, the reader will find studies on animal models of mental disorders and therapeutic interventions, and pharmacoelectroencephalographic studies. Regular reviews report new methodologic approaches, and selected case reports provide hints for future research. ''Neuropsychobiology'' is a complete record of strategies and methodologies employed to study the biological basis of mental functions including their interactions with psychological and social factors.