Thursday, December 6, 2018

Increased Risk of Mental Illness in Youth Linked to Infection

Children and adolescents with infections appear to be at a heightened risk of mental disorders, suggests a report published Wednesday in JAMA Psychiatry.

“This study found associations between any treated infection and increased risks of all treated childhood and adolescent mental disorders, with the risks differing among specific mental disorders,” wrote Ole Köhler-Forsberg, M.D., of Aarhus University Hospital in Denmark and colleagues.

For the study, Köhler-Forsberg and colleagues analyzed information contained in the Danish nationwide registers on more than one million children and adolescents born in Denmark between January 1, 1995, and June 30, 2012. The researchers focused their analysis on records of infections requiring hospitalizations and less severe infections treated with only anti-infective medications such as antibiotics and antivirals in outpatient settings. They also examined mental health diagnoses made in a hospital and filled prescriptions for psychotropic medications.

The authors found that children who had been hospitalized with a severe infection were 84% more likely to be subsequently diagnosed with a mental disorder than children who had not been hospitalized with a severe infection. Children treated for less severe infections with anti-infective medications were 40% more likely to be subsequently diagnosed with a mental disorder compared with children who had not taken these medications. The disorders associated with the highest risks after infection were autistic spectrum disorder, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, oppositional defiant disorder, conduct disorder, personality and behavior disorders, schizophrenia spectrum disorders, and tic disorders, Köhler-Forsberg and colleagues noted.

Because this was an observational study, Forsberg and colleagues noted that “the results cannot prove causality.” Nonetheless, “these findings provide evidence for the involvement of infections and the immune system in the etiology of a wide range of mental disorders in children and adolescents,” they added.

“These results bring a sense of urgency to detailing the underlying mechanisms of this association, in particular because of the possibility that these severe and occasionally permanent neuropsychiatric conditions might be rapidly recognized and treated by pharmacological compounds already in clinical use,” Viviane Labrie, Ph.D., and Lena Brundin, M.D., Ph.D., of Van Andel Research Institute, wrote in an accompanying editorial. In the piece, Labrie and Brundin described several mechanisms by which exposure to infections may increase risk of mental illness.

For related information, see the Psychiatric News article “Can Childhood Infections Trigger Mental Disorders?

(iStock/Stígur Már Karlsson/Heimsmyndir)


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