Related Experiment Video
Updated: Aug 20, 2025
Non-Invasive Model of Neuropathogenic Escherichia coli Infection in the Neonatal Rat
Published on: October 29, 2014
Risk of Major Mental Disorder after Severe Bacterial Infections in Children and Adolescents: A Nationwide
Tien-Wei Hsu1, Che-Sheng Chu1,2,3,4, Shih-Jen Tsai5,6
1Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Introduction:
Evidence has suggested an association between bacterial infection and increased risk of subsequent major mental disorders (MMDs). Whether such association varies with different pathogens remains unclear. We aimed to investigate the risk of subsequent MMDs after exposure to bacterial pathogens in children and adolescents.
Methods:
Between 1997 and 2012, we enrolled a nationwide cohort of 14,024 children and adolescents with hospitalized bacterial infection, and noninfected controls were 1:4 matched for demographics. There were 11 investigated pathogens, namely, Streptococcus, Staphylococcus, Pseudomonas, Klebsiella, Hemophilus, Mycoplasma, Tuberculosis, Meningococcus, Escherichia, Chlamydia, and Scrub typhus. The primary outcomes were the subsequent risk of seven MMDs, namely, autism spectrum disorder (ASD), attention-deficiency hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), tic disorder, schizophrenia, bipolar disorder, and depressive disorder. The secondary outcomes were the subsequent risk of exposure to psychotropic medications.
Results:
Pooled bacterial infection was associated with increased risk of the six MMDs - ASD (reported as hazard ratios with 95% confidence intervals: 13.80; 7.40-25.75), ADHD (6.93; 5.98-8.03), OCD (3.93; 1.76-8.76), tic disorder (6.19; 4.44-8.64), bipolar disorder (2.50; 1.28-4.86), and depressive disorder (1.93; 1.48-2.51) - and exposure to four psychotropic medications, including ADHD drugs (11.81; 9.72-14.35), antidepressants (2.96; 2.45-3.57), mood stabilizers (4.51; 2.83-7.19), and atypical antipsychotics (4.23; 3.00-5.96) compared to controls. The associations among MMDs and specific pathogens varied. Importantly, Streptococcus was associated with the most MMDs (six MMDs), and ADHD was associated with eight bacterial pathogen infections.
Conclusions:
After bacterial infection, the risk of MMDs increased in children and adolescents compared to controls, and such associations varied with different pathogens. Future studies are warranted to validate our study findings and investigate the potential mechanisms.
Insights
Bacterial infections in children and adolescents significantly increase the risk of developing major mental disorders (MMDs) like autism and ADHD. The specific pathogen influences the risk and type of MMD, highlighting the need for further research.
Area of Science:
- Pediatric Infectious Diseases
- Neuropsychiatry
- Epidemiology
Background:
- Growing evidence links bacterial infections to an elevated risk of major mental disorders (MMDs).
- The specific impact of different bacterial pathogens on MMD risk in pediatric populations remains largely uncharacterized.
Purpose of the Study:
- To investigate the association between hospitalized bacterial infections in children and adolescents and the subsequent risk of developing MMDs.
- To explore how different bacterial pathogens influence the risk of specific MMDs.
Main Methods:
- A nationwide cohort study of 14,024 children and adolescents with bacterial infections (1997-2012).
- 1:4 matching with non-infected controls based on demographics.
- Assessment of risk for seven MMDs (including autism spectrum disorder, ADHD, schizophrenia) and psychotropic medication exposure.
Main Results:
- Pooled bacterial infection correlated with increased risks for six MMDs, including autism spectrum disorder (HR 13.80) and ADHD (HR 6.93).
- Significant associations were found with psychotropic medication use (e.g., ADHD drugs HR 11.81).
- Streptococcus infection was linked to the most MMDs, and ADHD was associated with eight different bacterial pathogens.
Conclusions:
- Bacterial infections in pediatric populations are associated with a higher risk of subsequent MMDs compared to uninfected controls.
- The specific bacterial pathogen plays a role in the type and magnitude of MMD risk.
- Further research is necessary to confirm these findings and elucidate underlying biological mechanisms.
Related Concept Videos
01:30Stress and Mental Health
Individuals with depression often experience challenges in both their personal and professional...
01:29Psychological and Sociocultural Causes of Schizophrenia
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:30Bulimia Nervosa
01:29Biological Causes of Schizophrenia
Genetic Factors in Schizophrenia
The genetic basis of schizophrenia is strongly supported by family and twin...