Increase the risk of intellectual disability in children with scabies: A nationwide population-based cohort study
Jui-Ming Liu1, Ren-Jun Hsu, Fung-Wei Chang
1Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan Department of Medicine, National Yang-Ming University Graduate Institute of Life Sciences Biobank Management Center of the Tri-Service General Hospital Department of Pathology and Graduate Institute of Pathology and Parasitology Department of Obstetrics & Gynecology, Tri-Service General Hospital, National Defense Medical Center Institute of Bioinformatics and System Biology, National Chiao Tung University, Hsinchu School of Chinese Medicine, College of Chinese Medicine, China Medical University Department of Nursing, College of Medical and Health Science, Asia University Department of Pediatrics, BinKun Women's and Children's Hospital, Taoyuan Department of Pediatrics, MacKay Children's Hospital, Taipei Department of Medicine, MacKay Medical College, New Taipei City Department of Pediatrics and Infectious Disease, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan Division of Infection and Pathway Medicine, College of Medicine and Veterinary Medicine, the University of Edinburgh, Edinburgh, United Kingdom.
Insights
Children with scabies have a doubled risk of developing psychiatric disorders in childhood (PDC), including intellectual disability (ID). Early scabies treatment may reduce the risk of subsequent ID, suggesting comprehensive care for both conditions.
Area of Science:
- Dermatology
- Pediatrics
- Psychiatry
Background:
- Scabies and childhood psychiatric disorders share similarities, including pruritus, prevalence in lower socioeconomic groups, and immune-mediated inflammatory processes.
- An association between scabies and psychiatric disorders in childhood (PDC) is plausible due to shared pathophysiology.
Purpose of the Study:
- To investigate the relationship between scabies and the subsequent development of PDC using a nationwide population-based cohort.
- To identify specific psychiatric disorders, such as intellectual disability (ID), associated with scabies in children.
Main Methods:
- A nationwide population-based cohort study utilized data from the National Health Insurance Research Database.
- 2137 children diagnosed with scabies were compared to 8548 age- and sex-matched controls over a 7-year follow-up period.
Main Results:
- Children with scabies showed a significantly higher risk of developing intellectual disability (ID) (adjusted hazard ratio: 2.04).
- The study identified a 104% increased risk related to immune-mediated inflammatory processes in scabies patients, potentially linking to ID development.
Conclusions:
- Scabies infection in children is associated with an increased risk of developing intellectual disability (ID).
- Comprehensive management of scabies and concurrent evaluation for ID are recommended for affected children.
- Early and thorough treatment of scabies may mitigate the risk of subsequent ID development.
Abstract:
Scabies is a common and distressing disease caused by the mite Sarcoptes scabiei var. hominis. Psychiatric disorder in childhood is an important disease and easily neglected. There are several similarities in scabies and psychiatric disorders in childhood (PDC). Both of them may present with pruritus. They are relatively common in patients with lower socioeconomic status and crowded environment. Furthermore, immune-mediated inflammatory processes play a role in the pathophysiology in both diseases. An association between scabies and psychiatric disorders may exist. This nationwide population-based cohort study utilized data from the National Health Insurance Research Database to investigate the relationship between scabies and PDC. A total of 2137 children with scabies were identified as the study group and 8548 age- and sex-matched children were selected as the control group. A total of 607 (5.68%) children developed PDC during the 7-year follow-up period. The overall incidences of PDC are similar but patients with scabies had a higher risk of developing intellectual disability (ID) (scabies group vs control group: 1.3% vs 0.6%, adjusted hazard ratio: 2.04 and 95% confidence interval: 1.25-3.32). The immune-mediated inflammatory processes of both diseases were reviewed and may contribute to the 104% increased risk of interleukin in patients with scabies. We suggest a more comprehensive management in treating patients with scabies or ID. Early and comprehensive treatment of scabies and other risk factors may decrease the risk of subsequent ID. When we approach patients with ID, concurrent evaluation of scabies and other risk factors may contribute to successful management.
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