Severe childhood infection is linked to some neuropsychiatric conditions

  • JAMA Psychiatry

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • A large Danish registry study has linked severe childhood infection with risk for some neuropsychiatric conditions.
  • The study involved children with severe infections requiring hospitalization and their contacts with hospitals because of neuropsychiatric conditions.
  • The strongest links were found for obsessive-compulsive disorder (OCD), tics, and intellectual disability.
  • Treatment for less severe infection using anti-infective agents increased risk, too.

Why this matters

Key results

  • Hazard rate ratios (95% CIs) for specific conditions with 2-fold increased risk (all significant):
    • Tic disorders: 3.33 (1.37-8.08).
    • OCD: 2.74 (1.42-5.31).
    • Oppositional defiant disorder (ODD): 3.23 (2.02-5.17).
    • Anxiety disorders: 2.06 (1.63-2.60).
    • Schizophrenia spectrum disorders: 1.80 (1.29-2.52).
    • Intellectual disability: 3.79 (2.55-5.63).
    • ADHD: 2.09 (1.78-2.46).
  • Risk also increased for OCD, ODD, and tic disorders among children treated with anti-infective agents. 
  • Sibling analysis results supported findings of increased risks.

Study design

  • Danish registry study, n=1,098,930; January 1, 1995-June 30, 2012; mean age at follow-up, 9.76 years; children had severe infections requiring hospitalization.
  • Outcomes: adjusted hazard rate ratios for hospital contact for neuropsychiatric conditions.
  • Funding: Lundbeck Foundation; Independent Research Fund Denmark.

Limitations

  • Adult-onset conditions not evaluated.
  • Causation not established.

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