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Recurrent antimicrobial exposure and acute psychosis
Evan Ketcham1, Brian J Miller2
1Medical College of Georgia, Augusta University, Augusta, Georgia, USA.
Summary
Recurrent infections and antimicrobial exposure are common in patients hospitalized for acute psychosis, particularly those with schizophrenia. This suggests infections may play a role in psychosis relapse.
Area of Science:
- Psychiatry
- Infectious Diseases
- Medical Microbiology
Background:
- Acute psychosis is increasingly associated with recent antimicrobial exposure.
- Previous research indicated recurrent urinary tract infections (UTIs) in some psychosis patients.
- This study investigates recurrent antimicrobial exposure in acutely ill psychosis inpatients.
Purpose of the Study:
- To determine the prevalence of recurrent antimicrobial exposure in patients hospitalized with acute psychosis.
- To explore the association between recurrent infections and specific psychotic disorders.
- To examine the relationship between infection and symptom presentation in psychosis.
Main Methods:
- Retrospective chart review of 85 patients (age 18-65) with multiple acute psychosis hospitalizations.
- Antimicrobial exposure defined as use within 3 days of psychiatric hospitalization.
- Recurrent infections defined as antimicrobial exposure during two or more separate hospitalizations.
Main Results:
- 26% of patients (22/85) exhibited recurrent antimicrobial exposure.
- Prevalence was 25% in schizophrenia and 26% in psychotic mood disorders.
- Schizophrenia patients with recurrent infections were more likely to have visual hallucinations (31% vs. 14%).
Conclusions:
- A subset of patients with schizophrenia and psychotic mood disorders experiences recurrent infections during acute psychosis hospitalizations.
- Findings support the association between recurrent UTIs and acute psychosis.
- Infections may be relevant to illness relapse in some psychosis patients, though mechanisms require further study.
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