Based on real-world data: Risk factors and prediction model for mental disorders induced by rabies vaccination.

Abstract

Background: Rabies is a zoonotic viral disease affecting the central nervous system, caused by the rabies virus, with a case-fatality rate of 100% once symptoms appear.

Aim: To analyze high-risk factors associated with mental disorders induced by rabies vaccination and to construct a risk prediction model to inform strategies for improving patients' mental health.

Methods: Patients who received rabies vaccinations at the Department of Infusion Yiwu Central Hospital between August 2024 and July 2025 were included, totaling 384 cases. Data were collected from medical records and included demographic characteristics (age, gender, occupation), lifestyle habits, and details regarding vaccine type, dosage, and injection site. The incidence of psychiatric disorders following vaccination was assessed using standardized anxiety and depression rating scales. Patients were categorized into two groups based on the presence or absence of anxiety and depression symptoms: The psychiatric disorder group and the non-psychiatric disorder group. Differences between the two groups were compared, and high-risk factors were identified using multivariate logistic regression analysis. A predictive model was then developed based on these factors to evaluate its predictive performance.

Results: Among the 384 patients who received rabies vaccinations, 36 cases (9.38%) were diagnosed with anxiety, 52 cases (13.54%) with depression, and 88 cases (22.92%) with either condition. Logistic regression analysis identified the following significant risk factors for psychiatric disorders: Education level of primary school or below, exposure site at the head and neck, exposure classified as grade III, family status of divorced/widowed/unmarried/living alone, number of wounds greater than one, and low awareness of rabies prevention and control (P < 0.05). The risk prediction model demonstrated good performance, with an area under the receiver operating characteristic curve of 0.859, a specificity of 74.42%, and a sensitivity of 93.02%.

Conclusion: In real-world settings, psychiatric disorders following rabies vaccination are relatively common and are associated with factors such as lower education level, higher exposure severity, vulnerable family status, and limited awareness of rabies prevention and control. The developed risk prediction model may aid in early identification of high-risk individuals and support timely clinical intervention.