Acutely ill psychiatric inpatients and antimicrobial exposure

Area of Science:

• Psychiatry
• Infectious Diseases
• Epidemiology

Background:

• Patients with schizophrenia, bipolar disorder, and major depressive disorder (MDD) exhibit a higher incidence of infections.
• The relationship between recent antimicrobial exposure and acute psychiatric illness requires further investigation.

Purpose of the Study:

• To explore the association between recent antimicrobial exposure and acute psychiatric illness.
• To determine if antimicrobial use precedes psychiatric hospitalization in patients with schizophrenia, bipolar disorder, MDD, or alcohol use disorders.

Main Methods:

• A retrospective chart review was conducted on 267 acutely ill patients aged 18-65.
• Patients were categorized into schizophrenia, bipolar disorder, MDD, and alcohol use disorder (control) groups.
• Recent antimicrobial exposure was defined as use within 3 days of psychiatric hospitalization.

Main Results:

• A significantly higher prevalence of recent antimicrobial exposure was observed in patients with schizophrenia (16%), bipolar disorder (21%), and MDD (18%) compared to controls (4%).
• After adjusting for confounders, patients with schizophrenia or mood disorders were 5 to 7 times more likely to have recent antimicrobial exposure than those with alcohol use disorders.
• The association was particularly strong for depression and affective psychosis within the mood disorder group.

Conclusions:

• An increased prevalence of recent antimicrobial exposure was found in acutely ill patients diagnosed with schizophrenia and mood disorders.
• These findings support the relevance of infections in the context of acute psychiatric illness.