scholarly journals Early exposure to antibiotic drugs and risk for psychiatric disorders: a population-based study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Catharina Lavebratt ◽  
Liu L. Yang ◽  
MaiBritt Giacobini ◽  
Yvonne Forsell ◽  
Martin Schalling ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Emotional Disorders ◽  
Early Life ◽  
Drug Exposure ◽  
Wide Spectrum ◽  
Cox Proportional Hazards ◽  
Childhood Development ◽  
Fetal Life ◽  
Increased Risk ◽  
Antibiotic Drug

AbstractEarly life exposure to infection, anti-infectives and altered immune activity have been associated with elevated risk of some psychiatric disorders. However, the risk from exposure in fetal life has been proposed to be confounded by familial factors. The hypothesis of this study is that antibiotic drug exposure during the fetal period and the first two postnatal years is associated with risk for later development of psychiatric disorders in children. All births in Finland between 1996 and 2012, 1 million births, were studied for antibiotic drug exposure: mothers during pregnancy and the children the first two postnatal years. The children were followed up for a wide spectrum of psychiatric diagnoses and psychotropic drug treatment until 2014. Cox proportional hazards modeling was used to estimate effects of antibiotic drug exposure on offspring psychiatric disorders. Modestly (10–50%) increased risks were found on later childhood development of sleep disorders, ADHD, conduct disorder, mood and anxiety disorders, and other behavioral and emotional disorders with childhood onset (ICD-10 F98), supported by increased risks also for childhood psychotropic medication. The prenatal exposure effects detected were not explained by explored familial confounding, nor by registered maternal infections. To conclude, this longitudinal nation-wide study shows that early life antibiotic drug exposure is associated with an increased risk for childhood development of psychopathology. Given the high occurrence of early-life antibiotic exposure, these findings are of public health relevance. Whether the associations reflect effects of the antibiotic drug use or of the targeted infections remains to be explored further.

scholarly journals Risk of psychiatric disorders among the surviving twins after a co-twin loss

eLife ◽  
2020 ◽  
Vol 9 ◽  
Author(s):  
Huan Song ◽  
Henrik Larsson ◽  
Fang Fang ◽  
Catarina Almqvist ◽  
Nancy L Pedersen ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Early Life ◽  
Genetic Factors ◽  
Genetic Relatedness ◽  
Life Experiences ◽  
Stressful Event ◽  
Relative Risks ◽  
Dizygotic Twins ◽  
Increased Risk ◽  
Age And Sex

Losing a co-twin by death is a severely stressful event yet with unknown impact on the surviving twin’s risk of psychiatric disorders. We identified all Swedish-born twins who lost a co-twin by death between 1973 and 2013 (n = 4,528), their 4939 non-twin full siblings, together with 22,640 age- and sex-matched non-bereaved twins. Compared to the non-bereaved twins, exposed twins were at increased risk of receiving a first diagnosis of psychiatric disorders (hazard ratio = 1.65, 95% confidence interval1.48–1.83), particularly during the first month after loss. Similarly, compared to non-twin full siblings, the relative risks were significantly increased after loss of monozygotic co-twin (2.45-fold), and loss of a dizygotic co-twin (1.29-fold), with higher HR observed with greater age gaps between twins and non-twin siblings. As dizygotic twins share equal genetic relatedness to the deceased twin as their full siblings, this pattern suggests that beyond the contribution of genetic factors, shared early life experiences and attachment contribute to the risk of psychiatric disorders among surviving twins after co-twin loss.

scholarly journals Investigating the potential effect of antihypertensive medication on psychiatric disorders: a mendelian randomisation study

2020 ◽  
Author(s):  
Solal Chauquet ◽  
Michael O’Donovan ◽  
James Walters ◽  
Naomi Wray ◽  
Sonia Shah
Keyword(s):  
Psychiatric Disorders ◽  
Drug Target ◽  
Drug Exposure ◽  
Causal Effect ◽  
Association Studies ◽  
Neuropsychiatric Symptoms ◽  
Potential Effect ◽  
Mendelian Randomisation ◽  
Genome Wide Association Studies ◽  
Increased Risk

ABSTRACTBackgroundThere is growing evidence from observational studies that drugs used for the prevention and treatment of CVD may cause, exacerbate, or relieve neuropsychiatric symptoms.AimUse Mendelian randomisation (MR) analysis to investigate the potential effect of different antihypertensive drugs on schizophrenia, bipolar disorder and major depressive disorder.MethodsWe conduct two sample MR using expression quantitative trait loci (eQTLs) for antihypertensive drug target genes as genetic instruments, together with summary data from published genome-wide association studies, to investigate the causal effect of changes in drug target gene expression (as proxies of drug exposure) on psychiatric disorders.ResultsA 1 standard deviation lower expression of the ACE gene in blood was associated with 4.0 mmHg (95% CI = 2.7 – 5.3) lower systolic blood pressure, but increased risk of schizophrenia (OR (95% CI) = 1.75 (1.28 – 2.38)). A concordant direction of effect was observed with ACE expression in brain tissue.ConclusionsFindings suggest an adverse effect of lower ACE expression on schizophrenia risk. This warrants further investigation to determine if lowering ACE activity for treatment of hypertension using ACE inhibitors (particularly centrally-acting drugs) may worsen symptoms in patients with schizophrenia, and whether there is any association between ACE inhibitor use and risk of (mainly late-onset) schizophrenia.

Interstitial lung disease is associated with an increased risk of lung cancer in systemic sclerosis: Longitudinal data from the Canadian Scleroderma Research Group

2018 ◽  
Vol 3 (3) ◽  
pp. 221-227 ◽  
Author(s):  
Lama Sakr ◽  
Marie Hudson ◽  
Mianbo Wang ◽  
Elie Younanian ◽  
Murray Baron ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systemic Sclerosis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Research Group ◽  
Drug Exposure ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Smoking History ◽  
Increased Risk

Objective: The literature supports an increased risk of malignancy in systemic sclerosis, including lung cancer. Our objective was to identify potential independent predictors of lung cancer risk in systemic sclerosis. Methods: We used a cohort of 1560 systemic sclerosis patients from the Canadian Scleroderma Research Group, enrolled from 2004 and followed for a maximum of 11 years. Time to lung cancer was calculated from the onset of the first non-Raynaud’s symptoms. Baseline demographic, clinical, and serological characteristics of patients with and without lung cancer were compared. Cox proportional hazards models were used to estimate the effects of demographic variables, exposure to smoking, disease duration, disease subset (diffuse vs limited), immunosuppressant drug exposure, and presence of interstitial lung disease on the risk of lung cancer. Results: Over the 5519 total person-years of follow-up, 18 SSc patients were diagnosed with lung cancer after cohort entry (3.2 cancers per 1000 person-years). In univariate comparisons, cancer cases were more likely to be male, to have a smoking history, and to have interstitial lung disease than non-cases. In multivariate analysis, interstitial lung disease was independently associated with the risk of lung cancer (hazard ratio: 2.95, 95% confidence interval: 1.10–7.87). Conclusion: In addition to known demographic (male sex) and lifestyle risk factors (smoking), interstitial lung disease is an independent risk factor for lung cancer in systemic sclerosis. These results have implications for lung cancer screening in systemic sclerosis.

scholarly journals Psychiatric disorders risk in patients with iron deficiency anemia and association with iron supplementation medications: a nationwide database analysis

2019 ◽  
Author(s):  
Herng-Sheng Lee ◽  
Hsin-Hao Chao ◽  
Wan-Ting Huang ◽  
Solomon Chih-Cheng Chen ◽  
Hsin-Yi Yang
Keyword(s):  
Iron Deficiency ◽  
Sleep Disorders ◽  
Psychiatric Disorders ◽  
Iron Deficiency Anemia ◽  
Iron Supplementation ◽  
Psychotic Disorders ◽  
Psychiatric Morbidity ◽  
Cox Proportional Hazards ◽  
Deficiency Anemia ◽  
Increased Risk

Abstract Background It has been shown that iron deficiency anemia (IDA) is associated with psychosocial consequences and psychiatric morbidity. However, the association between adults with IDA and psychiatric disorders has not been clarified. The purpose of this study is to investigate the psychiatric disorders morbidity of IDA in comparison with non-IDA group and to examine the risk of psychiatric disorders in IDA patients treated with iron supplementary.Methods All study subjects aged ≥ 20 years with newly diagnosed IDA in the Taiwan National Health Insurance Database during 2000-2012 were enrolled. We matched IDA and non-IDA subjects according to age and gender in a 1:2 ratio. Our primary outcome was diagnosis of psychiatric disorders and the patients were monitored until the end of 2013. The Cox proportional hazards regression model was used to evaluate the risk of psychiatric disorders events to occur in IDA.Results The adjusted hazard ratios (aHR) of psychiatric disorders was 1.49 (95% CI = 1.43 – 1.56) in the IDA group compared with the non-IDA group. Among the different type of psychiatric disorders occurrence, the IDA group was associated with significantly higher incidence and risks of dementia, anxiety disorders, depression, sleep disorders and psychotic disorders (p < 0.05). Furthermore, iron supplementation use to IDA subjects was associated with significantly lower risk of psychiatric disorders compared with IDA patients without iron supplementation.Conclusions Our study indicates that IDA had an increased risk of psychiatric disorders, regardless of other confounders. Moreover, in IDA patients, iron supplementation use could reduce the risk of psychiatric disorders, especially sleep disorders.

scholarly journals Aspirin and other non-steroidal anti-inflammatory drugs and depression, anxiety, and stress-related disorders following a cancer diagnosis: a nationwide register-based cohort study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Kejia Hu ◽  
Arvid Sjölander ◽  
Donghao Lu ◽  
Adam K. Walker ◽  
Erica K. Sloan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Psychiatric Disorders ◽  
Cancer Diagnosis ◽  
Cox Proportional Hazards ◽  
First Year ◽  
Primary Malignancy ◽  
Increased Risk ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
After Cancer

Abstract Background Cancer patients have a highly increased risk of psychiatric disorders following diagnosis, compared with cancer-free individuals. Inflammation is involved in the development of both cancer and psychiatric disorders. The role of non-steroidal anti-inflammatory drugs (NSAIDs) in the subsequent risk of psychiatric disorders after cancer diagnosis is however unknown. Methods We performed a cohort study of all patients diagnosed with a first primary malignancy between July 2006 and December 2013 in Sweden. Cox proportional hazards models were used to assess the association of NSAID use during the year before cancer diagnosis with the risk of depression, anxiety, and stress-related disorders during the first year after cancer diagnosis. Results Among 316,904 patients identified, 5613 patients received a diagnosis of depression, anxiety, or stress-related disorders during the year after cancer diagnosis. Compared with no use of NSAIDs, the use of aspirin alone was associated with a lower rate of depression, anxiety, and stress-related disorders (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.81 to 0.97), whereas the use of non-aspirin NSAIDs alone was associated with a higher rate (HR, 1.24; 95% CI, 1.15 to 1.32), after adjustment for sociodemographic factors, comorbidity, indications for NSAID use, and cancer characteristics. The association of aspirin with reduced rate of depression, anxiety, and stress-related disorders was strongest for current use (HR, 0.84; 95% CI, 0.75 to 0.93), low-dose use (HR, 0.88; 95% CI, 0.80 to 0.98), long-term use (HR, 0.84; 95% CI, 0.76 to 0.94), and among patients with cardiovascular disease (HR, 0.81; 95% CI, 0.68 to 0.95) or breast cancer (HR, 0.74; 95% CI, 0.56 to 0.98). Conclusion Pre-diagnostic use of aspirin was associated with a decreased risk of depression, anxiety, and stress-related disorders during the first year following cancer diagnosis.

scholarly journals Loss of a co-twin at birth and subsequent risk of psychiatric disorders

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Huan Song ◽  
Fang Fang ◽  
Henrik Larsson ◽  
Nancy L Pedersen ◽  
Patrik KE Magnusson ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Emotional Disorders ◽  
Hazard Ratio ◽  
Increased Risk ◽  
First Onset ◽  
Birth Characteristics ◽  
Subsequent Risk

Twins suffering a co-twin loss at birth have reported feelings of loneliness and grief while it remains unexplored if they suffer increased risk of psychiatric disorders. We contrasted rate of first-onset psychiatric disorders among all Swedish-born twins whose co-twin died within 60 days after birth between 1973 and 2011 (n = 787) to that of 3935 matched unexposed twins, 3935 matched singletons (both matched to the exposed twins by birth year, sex, and birth characteristics), and 880 full siblings of the exposed twins. During a median of 19-year follow-up, exposed twins were at increased risk of first-onset psychiatric disorders (hazard ratio = 1.56, 95%CI 1.30–1.87) compared with unexposed twins. We observed the strongest association for emotional disorders and for psychiatric disorders diagnosed before the age of 25. Comparisons with matched singletons and the twin’s full siblings rendered similar results, corroborating an association of loss of a co-twin at birth with subsequent risk of psychiatric disorders.

scholarly journals Early Life Stress, Mood, and Anxiety Disorders

2017 ◽  
Vol 1 ◽  
pp. 247054701769446 ◽  
Author(s):  
Shariful A. Syed ◽  
Charles B. Nemeroff
Keyword(s):  
Psychiatric Disorders ◽  
Life Stress ◽  
Early Life ◽  
Wide Spectrum ◽  
Early Life Stress ◽  
Research Domain Criteria ◽  
Long Term Effects ◽  
Research Perspective ◽  
Discrete Domains ◽  
Research Domain

Early life stress has been shown to exert profound short- and long-term effects on human physiology both in the central nervous system and peripherally. Early life stress has demonstrated clear association with many psychiatric disorders including major depression, posttraumatic stress disorder, and bipolar disorder. The Diagnostic and Statistics Manuel of Mental Disorders (DSM) diagnostic categorical system has served as a necessary framework for clinical service, delivery, and research, however has not been completely matching the neurobiological research perspective. Early life stress presents a complex dynamic featuring a wide spectrum of physiologic alterations: from epigenetic alterations, inflammatory changes, to dysregulation of the hypothalamic pituitary axis and has further added to the challenge of identifying biomarkers associated with psychiatric disorders. The National Institute of Mental Health’s proposed Research Domain Criteria initiative incorporates a dimensional approach to assess discrete domains and constructs of behavioral function that are subserved by identifiable neural circuits. The current neurobiology of early life stress is reviewed in accordance with dimensional organization of Research Domain Criteria matrix and how the findings as a whole fit within the Research Domain Criteria frameworks.

scholarly journals Risk of Gastrointestinal Events in Patients with Rheumatoid Arthritis After Withdrawal of Rofecoxib

2012 ◽  
Vol 39 (5) ◽  
pp. 910-915 ◽  
Author(s):  
CARLO A. MARRA ◽  
LARRY D. LYND ◽  
LINDSEY COLLEY ◽  
STEPHANIE S. HARVARD ◽  
DIANE LACAILLE ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Drug Exposure ◽  
Proportional Hazards ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Antiinflammatory Drugs ◽  
Increased Risk ◽  
Cox 2 ◽  
Cox 2 Inhibitors

Objective.To examine the incidence of gastrointestinal (GI) events in patients with rheumatoid arthritis (RA) after the removal of rofecoxib from the market.Methods.Residents of British Columbia with a diagnosis of RA who were chronic users of cyclooxygenase 2 (COX-2) inhibitors or nonselective nonsteroidal antiinflammatory drugs (nsNSAID) as of September 30, 2004, were included. We studied the risk of GI events using incidence rates and adjusted HR from Cox proportional hazards regression using time-dependent covariates.Results.The cohort comprised 4266 patients with a mean age of 60 years and over 72% women, of which 2034 (48%) were classified as COX-2 inhibitor users and 2232 (52%) as chronic nsNSAID users as of September 30, 2004. The 2 groups were well balanced on baseline covariates except for comorbid conditions. In the year following rofecoxib withdrawal, 174 patients (5.5%) experienced 1 or more GI events, defined as a GI-related physician visit or hospitalization. There was no statistically significant increase in the risk of a GI event between those classified as a COX-2 inhibitor or nsNSAID user at the time of withdrawal (HR 1.03, 95% CI 0.69–1.54). Considering the drug exposure at the time of the event, there was no increased risk of GI events associated with the use of either COX-2 inhibitors or nsNSAID, or with the use of oral corticosteroids, low-dose aspirin, or clopidogrel, after adjustment for potential confounders.Conclusion.In this cohort, withdrawal of rofecoxib did not result in a significant increase in GI events among patients with RA.

scholarly journals Neurodevelopmental and psychiatric disorders in females with Turner syndrome: a population-based study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Hanna Björlin Avdic ◽  
Agnieszka Butwicka ◽  
Anna Nordenström ◽  
Catarina Almqvist ◽  
Agneta Nordenskjöld ◽  
...  
Keyword(s):  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Turner Syndrome ◽  
Emotional Disorders ◽  
Conditional Logistic Regression ◽  
Population Based ◽  
Autism Spectrum ◽  
Clinical Criteria ◽  
Increased Risk ◽  
National Patient

Abstract Background Turner syndrome is the result of the partial or complete absence of an X chromosome in phenotypic girls. This can cause an array of medical and developmental difficulties. The intelligence quotient in females with Turner syndrome has previously been described as uneven, but considered within normal range. Although their social, intellectual, and psychiatric profile is described, it is unclear to what extent these females meet the clinical criteria for neurodevelopmental or psychiatric diagnoses. The aim of this study was to examine the prevalence of neurodevelopmental and psychiatric disorders in females with Turner syndrome. Methods A retrospective cohort study was performed with a total of 1392 females with Turner syndrome identified through the Swedish National Patient Register and compared with 1:100 age- and sex-matched controls from the general population. The associations between Turner syndrome and diagnoses of neurodevelopmental and/or psychiatric disorders were calculated using conditional logistic regression and is presented as estimated risk (odds ratio, OR, 95% confidence interval, CI) in females with Turner syndrome compared with matched controls. Results Females with Turner syndrome had a higher risk of neurodevelopmental or psychiatric disorder (OR 1.37, 95% CI 1.20–1.57), an eightfold increased risk of intellectual disability (OR 8.59, 95% CI 6.58–11.20), and a fourfold increased risk of autism spectrum disorder (OR 4.26, 95% CI 2.94‑6.18) compared with the controls. In addition, females with Turner syndrome had twice the risk of a diagnosis of schizophrenia and related disorders (OR 1.98, 95% CI 1.36–2.88), eating disorders (OR 2.03, 95% CI 1.42–2.91), and behavioral and emotional disorders with onset in childhood (OR 2.01, 95% CI 1.35–2.99). Conclusions Females with Turner syndrome have an increased risk of receiving a diagnosis of neurodevelopmental or psychiatric disorder. This warrants extensive assessment of intellectual and cognitive functions from early age, and increased psychiatric vigilance should be a part of lifelong healthcare for females with Turner syndrome.

scholarly journals Antipsychotics, Prolactin and Breast Cancer

2021 ◽  
Author(s):  
Tahir Rahman ◽  
John Sahrmann ◽  
Margaret A. Olsen ◽  
Katelin B. Nickel ◽  
j Philip Miller ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Antipsychotic Drug ◽  
Invasive Breast Cancer ◽  
Antipsychotic Drugs ◽  
Drug Exposure ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Serum Prolactin ◽  
Cox Proportional Hazards Models ◽  
Increased Risk

Objective: Antipsychotic drugs are well established to alter circulating prolactin levels by blocking dopamine D-2 receptors in the pituitary. Prolactin activates many genes important in the development of breast cancer. The aim of this study was to evaluate the risk of breast cancer in women exposed to antipsychotic drugs, stratified by prolactin elevating potential (high, mid, and low), compared to women taking anticonvulsants and/or lithium. Methods: The IBM MarketScan Commercial and Medicaid Databases were used to establish a large, observational cohort of women taking antipsychotics drugs compared to control drugs. Invasive breast cancer was identified using diagnostic codes. Bivariable and multivariable Cox proportional hazards models were used to evaluate the risk of breast cancer by antipsychotic drug exposure, both as pooled antipsychotics and by prolactin specific categories. Results: A total of 2,708 (0.2%) cases of invasive breast cancer were identified among 1,562,839 women. Exposure to antipsychotics with high prolactin elevating potential was associated with a 23% increased risk of breast cancer (aHR 1.23; 95% CI, 1.11-1.35), whereas mid and low prolactin categories of antipsychotics were not significant. Conclusion: In the largest study of antipsychotics taken by women, a modest risk between antipsychotic drug use and the risk for breast cancer was observed, with a differential higher association with high prolactin elevating drugs. Residual confounding factors included incomplete information on parity, race and socioeconomic status, and differential outpatient visits. Clinicians should consider monitoring serum prolactin levels and adopting vigilant mammography screening practices, especially in older women taking category one antipsychotics.

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