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Hospital admission with infection during childhood and risk for psychotic illness--a population-based cohort study.
Schizophr Bull. 2014 Nov; 40(6):1518-25.SB

Abstract

A growing body of literature suggests that exposure to infections, particularly maternal infections, during pregnancy confers risk for later development of psychotic disorder. Though brain development proceeds throughout childhood and adolescence, the influence of infections during these ages on subsequent psychosis risk is insufficiently examined. The aim of this study was to investigate the potential association between infections during childhood and nonaffective psychoses in a large population-based birth cohort with follow up long enough to include peak incidence of nonaffective psychosis. We included all individuals born in Sweden between 1973 and 1985, (N = 1172879), with follow up on first time inpatient care with nonaffective psychosis from age 14 years until 2006, (N = 4638). Following adjustment for differences in sex, socioeconomic status, family history of psychosis, and hospital admissions involving noninfectious, nonpsychiatric care, we observed a small but statistically significant association between hospital admissions for infections, in general, throughout childhood (0-13 years) and a later diagnosis of nonaffective psychosis, hazard ratio (HR) = 1.10 (95% CI 1.03-1.18), and this association seemed to be driven by bacterial infection, HR = 1.23 (95% CI 1.08-1.40). Bacterial infections and central nervous system infections during preadolescence (10-13 years) conferred the strongest risk, HR 1.57 (95% CI 1.21-2.05) and HR 1.96 (95% CI 1.05-3.62), respectively. Although preadolescence appeared to be a vulnerable age period, and bacterial infection the most severe in relation to psychosis development, the present findings can also indicate an increased susceptibility to hospital admission for infections among children who will later develop nonaffective psychosis due to social or familial/genetic factors.

Authors+Show Affiliations

Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; asa.blomstrom@ki.se.Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden;Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden;Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden;Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia.Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden;Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden;Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden;

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24366719

Citation

Blomström, Åsa, et al. "Hospital Admission With Infection During Childhood and Risk for Psychotic Illness--a Population-based Cohort Study." Schizophrenia Bulletin, vol. 40, no. 6, 2014, pp. 1518-25.
Blomström Å, Karlsson H, Svensson A, et al. Hospital admission with infection during childhood and risk for psychotic illness--a population-based cohort study. Schizophr Bull. 2014;40(6):1518-25.
Blomström, Å., Karlsson, H., Svensson, A., Frisell, T., Lee, B. K., Dal, H., Magnusson, C., & Dalman, C. (2014). Hospital admission with infection during childhood and risk for psychotic illness--a population-based cohort study. Schizophrenia Bulletin, 40(6), 1518-25. https://doi.org/10.1093/schbul/sbt195
Blomström Å, et al. Hospital Admission With Infection During Childhood and Risk for Psychotic Illness--a Population-based Cohort Study. Schizophr Bull. 2014;40(6):1518-25. PubMed PMID: 24366719.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospital admission with infection during childhood and risk for psychotic illness--a population-based cohort study. AU - Blomström,Åsa, AU - Karlsson,Håkan, AU - Svensson,Anna, AU - Frisell,Thomas, AU - Lee,Brian K, AU - Dal,Henrik, AU - Magnusson,Cecilia, AU - Dalman,Christina, Y1 - 2013/12/23/ PY - 2013/12/25/entrez PY - 2013/12/25/pubmed PY - 2015/6/20/medline KW - cohort study KW - epidemiology KW - prenatal KW - psychosis KW - schizophrenia SP - 1518 EP - 25 JF - Schizophrenia bulletin JO - Schizophr Bull VL - 40 IS - 6 N2 - A growing body of literature suggests that exposure to infections, particularly maternal infections, during pregnancy confers risk for later development of psychotic disorder. Though brain development proceeds throughout childhood and adolescence, the influence of infections during these ages on subsequent psychosis risk is insufficiently examined. The aim of this study was to investigate the potential association between infections during childhood and nonaffective psychoses in a large population-based birth cohort with follow up long enough to include peak incidence of nonaffective psychosis. We included all individuals born in Sweden between 1973 and 1985, (N = 1172879), with follow up on first time inpatient care with nonaffective psychosis from age 14 years until 2006, (N = 4638). Following adjustment for differences in sex, socioeconomic status, family history of psychosis, and hospital admissions involving noninfectious, nonpsychiatric care, we observed a small but statistically significant association between hospital admissions for infections, in general, throughout childhood (0-13 years) and a later diagnosis of nonaffective psychosis, hazard ratio (HR) = 1.10 (95% CI 1.03-1.18), and this association seemed to be driven by bacterial infection, HR = 1.23 (95% CI 1.08-1.40). Bacterial infections and central nervous system infections during preadolescence (10-13 years) conferred the strongest risk, HR 1.57 (95% CI 1.21-2.05) and HR 1.96 (95% CI 1.05-3.62), respectively. Although preadolescence appeared to be a vulnerable age period, and bacterial infection the most severe in relation to psychosis development, the present findings can also indicate an increased susceptibility to hospital admission for infections among children who will later develop nonaffective psychosis due to social or familial/genetic factors. SN - 1745-1701 UR - https://www.unboundmedicine.com/medline/citation/24366719/Hospital_admission_with_infection_during_childhood_and_risk_for_psychotic_illness__a_population_based_cohort_study_ L2 - https://academic.oup.com/schizophreniabulletin/article-lookup/doi/10.1093/schbul/sbt195 DB - PRIME DP - Unbound Medicine ER -