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Urinary tract infections in children and adolescents with acute psychosis
Chelsea M Carson1, Niju Phillip1, Brian J Miller1
1Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States.
Insights
Urinary tract infections (UTIs) are more common in children and adolescents with acute non-affective psychosis. Screening for UTIs in these young patients is recommended.
Area of Science:
- Pediatric Psychiatry
- Infectious Diseases
- Clinical Psychology
Background:
- Schizophrenia and other psychotic disorders are linked to higher infection rates.
- Previous research indicated a correlation between urinary tract infections (UTIs) and acute psychosis in adults.
Purpose of the Study:
- To determine the prevalence of UTIs in pediatric patients with non-affective psychosis or psychotic depression compared to those with non-psychotic major depressive disorder (MDD).
- To compare demographic and clinical characteristics of pediatric patients with acute psychosis, with and without comorbid UTIs.
Main Methods:
- A retrospective chart review was conducted on 227 subjects aged 10-18 hospitalized between 2005 and 2014.
- Subjects were categorized into three groups: non-affective psychosis (n=80), MDD with psychotic features (n=47), and MDD without psychotic features (n=100).
Main Results:
- The prevalence of UTI was 20% in non-affective psychosis, 9% in MDD with psychotic features, and 13% in non-psychotic MDD.
- UTI was 3.5 times more likely in pediatric patients with non-affective psychosis compared to those with non-psychotic MDD (OR=3.5, p=0.01).
- Subjects with UTI showed a higher prevalence of manic symptoms, with no other significant clinical associations found.
Conclusions:
- An association exists between UTIs and pediatric acute non-affective psychosis.
- These findings underscore the importance of screening for comorbid UTIs in children and adolescents presenting with acute psychosis.
Objective:
Schizophrenia is associated with increased infections. We previously found an association between urinary tract infection (UTI) and acute psychosis in adults. The aims of this study were to 1) evaluate the prevalence of UTI at the time of admission in children and adolescents with non-affective psychosis and psychotic depression versus those with non-psychotic major depressive disorder, and 2) compare demographic and clinical features between children and adolescents with acute psychosis with and without comorbid UTI.
Method:
We performed a retrospective chart review of 227 subjects ages 10-18 who were hospitalized between 2005 and 2014 for an acute episode of DSM-IV non-affective psychosis (schizophrenia, schizoaffective disorder, psychosis NOS, or delusional disorder; n=80), major depressive disorder (MDD) with psychotic features (n=47); or MDD without psychotic features (n=100).
Results:
The prevalence of UTI was 20% in non-affective psychosis, 9% in MDD with psychotic features, and 13% in non-psychotic MDD. After controlling for potential confounders, UTI was 3.5 times more likely in subjects with non-affective psychosis than non-psychotic MDD (OR=3.5, 95% CI 1.3-9.2, p=0.01). Subjects with UTI had a higher prevalence of manic symptoms, but otherwise there were no associations between clinical characteristics and UTI in acute psychosis.
Conclusions:
We found an association between UTIs and children and adolescents with acute non-affective psychosis. The results highlight the potential importance of screening for comorbid UTI in patients with acute psychosis.
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