- Severe stress reactions in clinically diagnosed stress-related disorders (especially those diagnosed in early life) increase the risk of life-threatening infections in short- and long-term.
Why this matters
- Persistent use of selective serotonin reuptake inhibitors (SSRIs) in first year following diagnosis helps attenuate life-threatening infections risk.
- Consider consult with psychiatric specialist, regular mental-health follow-up, especially in childhood/adolescence.
- 144,919 stress-related disorders cohort, 1,449,190 matched cohort (184,612 siblings).
- 4843 with incident life-threatening infections (2197 stress disorders, 2656 unaffected siblings) identified.
- Life-threatening infections risk: any stress-related disorder (HR, 1.47; 95% CI, 1.37-1.58), posttraumatic stress disorder (HR, 1.92; 95% CI, 1.46-2.52), acute stress reaction (HR, 1.43; 95% CI, 1.29-1.58), adjustment disorder/others (HR, 1.48; 95% CI, 1.33-1.64).
- Overall, stress-related disorders linked to all studied life-threatening infections, with strongest association observed in persons without other severe somatic diseases/other psychiatric disorders (P<.001 within first year postdiagnosis>
- SSRI use linked to lower infection risk after 1 year (HR, 0.81; 95% CI, 0.66-0.98; P=.03).
- Population-based, sibling-controlled Swedish cohort study exploring link between stress-related disorders, life-threatening infections (e.g., sepsis, endocarditis, central nervous system, fatal infections) risk, 1987-2013.
- Funding: Grant of Excellence, others.
- Underestimated case numbers.
- Limited confounders data (including behaviors, therapy, etc.).
- Limited generalisability.