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Childhood infection and subsequent risk of psychotic disorders in adults: A systematic review and meta-analysis.
Asian J Psychiatr. 2020 Dec; 54:102275.AJ

Abstract

OBJECTIVE

The effects of childhood infection exposure on the risk of subsequent psychosis are unclear and no overview is available. We conducted a meta-analysis to assess the link between childhood infection and the risk of psychosis in later life.

METHODS

We performed systematic searches of the PubMed and Embase databases to identify relevant articles published up to March 1, 2020. Random-effects models were used to pool the odds ratios [OR] of childhood infection and later psychosis.

RESULTS

Thirteen observational studies (seven on hospital exposure to infection and six on central nervous system (CNS) infection) were included in the meta-analysis. Hospital contact with any infection during childhood was associated with an increased risk of psychosis (OR, 1.27; 95 % confidence interval (CI), 1.13-1.44; p < 0.001; I2 = 84 %) or schizophrenia (OR, 1.44; 95 % CI, 1.19-1.73; p < 0.001; I2 = 54.2 %) later in life. In further analysis, the association also existed for children exposed to CNS infection (OR, 1.68; 95 % CI, 1.08-2.62; p = 0.021; I2 = 68.7 %). However, the risk was modulated by the timing and frequency of infection.

CONCLUSIONS

Our results suggest an increased risk of psychosis later in life with infection exposure in childhood. However, non-causal explanations for the association cannot be ruled out.

Authors+Show Affiliations

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China.State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China.State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China.Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, China. Electronic address: mayongchun2020@126.com.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32663796

Citation

Jiang, Hai-Yin, et al. "Childhood Infection and Subsequent Risk of Psychotic Disorders in Adults: a Systematic Review and Meta-analysis." Asian Journal of Psychiatry, vol. 54, 2020, p. 102275.
Jiang HY, Zhang X, Pan LY, et al. Childhood infection and subsequent risk of psychotic disorders in adults: A systematic review and meta-analysis. Asian J Psychiatr. 2020;54:102275.
Jiang, H. Y., Zhang, X., Pan, L. Y., & Ma, Y. C. (2020). Childhood infection and subsequent risk of psychotic disorders in adults: A systematic review and meta-analysis. Asian Journal of Psychiatry, 54, 102275. https://doi.org/10.1016/j.ajp.2020.102275
Jiang HY, et al. Childhood Infection and Subsequent Risk of Psychotic Disorders in Adults: a Systematic Review and Meta-analysis. Asian J Psychiatr. 2020;54:102275. PubMed PMID: 32663796.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Childhood infection and subsequent risk of psychotic disorders in adults: A systematic review and meta-analysis. AU - Jiang,Hai-Yin, AU - Zhang,Xue, AU - Pan,Li-Ya, AU - Ma,Yong-Chun, Y1 - 2020/07/01/ PY - 2020/04/18/received PY - 2020/06/27/revised PY - 2020/06/30/accepted PY - 2020/7/15/pubmed PY - 2021/6/22/medline PY - 2020/7/15/entrez KW - Antibiotic KW - Infections KW - Pathogen KW - Psychiatric SP - 102275 EP - 102275 JF - Asian journal of psychiatry JO - Asian J Psychiatr VL - 54 N2 - OBJECTIVE: The effects of childhood infection exposure on the risk of subsequent psychosis are unclear and no overview is available. We conducted a meta-analysis to assess the link between childhood infection and the risk of psychosis in later life. METHODS: We performed systematic searches of the PubMed and Embase databases to identify relevant articles published up to March 1, 2020. Random-effects models were used to pool the odds ratios [OR] of childhood infection and later psychosis. RESULTS: Thirteen observational studies (seven on hospital exposure to infection and six on central nervous system (CNS) infection) were included in the meta-analysis. Hospital contact with any infection during childhood was associated with an increased risk of psychosis (OR, 1.27; 95 % confidence interval (CI), 1.13-1.44; p < 0.001; I2 = 84 %) or schizophrenia (OR, 1.44; 95 % CI, 1.19-1.73; p < 0.001; I2 = 54.2 %) later in life. In further analysis, the association also existed for children exposed to CNS infection (OR, 1.68; 95 % CI, 1.08-2.62; p = 0.021; I2 = 68.7 %). However, the risk was modulated by the timing and frequency of infection. CONCLUSIONS: Our results suggest an increased risk of psychosis later in life with infection exposure in childhood. However, non-causal explanations for the association cannot be ruled out. SN - 1876-2026 UR - https://www.unboundmedicine.com/medline/citation/32663796/Childhood_infection_and_subsequent_risk_of_psychotic_disorders_in_adults:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1876-2018(20)30387-7 DB - PRIME DP - Unbound Medicine ER -
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