scholarly journals Doxycycline exposure during adolescence and future risk of non-affective psychosis and bipolar disorder: a total population cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fredrik Upmark ◽  
Hugo Sjöqvist ◽  
Joseph F. Hayes ◽  
Christina Dalman ◽  
Håkan Karlsson
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
Affective Psychosis ◽  
National Population Register ◽  
Increased Risk ◽  
Potential Benefits ◽  
Secondary Analyses ◽  
Register Studies ◽  
Synaptic Pruning ◽  
First Diagnosis

AbstractDoxycycline has been hypothesized to prevent development of severe mental illness (SMI) through the suppression of microglia, especially if administered during the intense synaptic pruning period of adolescence. However, results from register studies on potential benefits differ considerably. The aim of the present study was to determine whether doxycycline exposure during adolescence is associated with reduced SMI risk, and to investigate if a direct and specific causality is plausible. This is a Swedish national population register-based cohort study of all individuals born from 1993 to 1997, followed from the age of 13 until end of study at the end of 2016. The primary exposure was cumulative doxycycline prescription ≥3000 mg and outcomes were first diagnosis of non-affective psychosis (F20–F29) and first diagnosis of bipolar disorder (F30–F31). Causal effects were explored through Cox regressions with relevant covariates and secondary analyses of multilevel exposure and comparison to other antibiotics. We found no association between doxycycline exposure and risk of subsequent non-affective psychosis (adjusted hazard ratio (HR) 1.15, 95% CI 0.73–1.81, p = 0.541) and an increased risk of subsequent bipolar disorder (adjusted HR 1.95, 95% CI 1.49–2.55, p < 0.001). We do not believe the association between doxycycline and bipolar disorder is causal as similar associations were observed for other common antibiotics.

scholarly journals Association between maternal and paternal mental illness and risk of injuries in children and adolescents: nationwide register based cohort study in Sweden

BMJ ◽  
2020 ◽  
pp. m853 ◽  
Author(s):  
Alicia Nevriana ◽  
Matthias Pierce ◽  
Christina Dalman ◽  
Susanne Wicks ◽  
Marie Hasselberg ◽  
...  
Keyword(s):  
Mental Illness ◽  
Cohort Study ◽  
Rate Ratio ◽  
Parental Mental Illness ◽  
Affective Psychosis ◽  
Fall Injuries ◽  
Increased Risk ◽  
Adjusted Rate ◽  
Adjusted Rate Ratio ◽  
Parents With Mental Illness

Abstract Objective To determine the association between parental mental illness and the risk of injuries among offspring. Design Retrospective cohort study. Setting Swedish population based registers. Participants 1 542 000 children born in 1996-2011 linked to 893 334 mothers and 873 935 fathers. Exposures Maternal or paternal mental illness (non-affective psychosis, affective psychosis, alcohol or drug misuse, mood disorders, anxiety and stress related disorders, eating disorders, personality disorders) identified through linkage to inpatient or outpatient healthcare registers. Main outcome measures Risk of injuries (transport injury, fall, burn, drowning and suffocation, poisoning, violence) at ages 0-1, 2-5, 6-9, 10-12, and 13-17 years, comparing children of parents with mental illness and children of parents without mental illness, calculated as the rate difference and rate ratio adjusted for confounders. Results Children with parental mental illness contributed to 201 670.5 person years of follow-up, while children without parental mental illness contributed to 2 434 161.5 person years. Children of parents with mental illness had higher rates of injuries than children of parents without mental illness (for any injury at age 0-1, these children had an additional 2088 injuries per 100 000 person years; number of injuries for children with and without parental mental illness was 10 235 and 72 723, respectively). At age 0-1, the rate differences ranged from 18 additional transport injuries to 1716 additional fall injuries per 100 000 person years among children with parental mental illness compared with children without parental mental illness. A higher adjusted rate ratio for injuries was observed from birth through adolescence and the risk was highest during the first year of life (adjusted rate ratio at age 0-1 for the overall association between any parental mental illness that has been recorded in the registers and injuries 1.30, 95% confidence interval 1.26 to 1.33). Adjusted rate ratios at age 0-1 ranged from 1.28 (1.24 to 1.32) for fall injuries to 3.54 (2.28 to 5.48) for violence related injuries. Common and serious maternal and paternal mental illness was associated with increased risk of injuries in children, and estimates were slightly higher for common mental disorders. Conclusions Parental mental illness is associated with increased risk of injuries among offspring, particularly during the first years of the child’s life. Efforts to increase access to parental support for parents with mental illness, and to recognise and treat perinatal mental morbidity in parents in secondary care might prevent child injury.

Increased risk of bipolar disorder in patients with scabies: A nationwide population-based matched-cohort study

2017 ◽  
Vol 257 ◽  
pp. 14-20 ◽  
Author(s):  
Chien-Yu Lin ◽  
Fung-Wei Chang ◽  
Jing-Jung Yang ◽  
Chun-Hung Chang ◽  
Chia-Lun Yeh ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
Population Based ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Increased Risk

Association of neighborhood migrant density and subsequent risk of non-affective psychosis: a national, longitudinal cohort study

2019 ◽  
Author(s):  
Jennifer Dykxhoorn ◽  
James Bowes Kirkbride
Keyword(s):  
Cohort Study ◽  
Psychotic Disorders ◽  
Public Health Intervention ◽  
Public Mental Health ◽  
Neighborhood Environment ◽  
Visible Minority ◽  
Protective Effects ◽  
Minority Status ◽  
Affective Psychosis ◽  
Increased Risk

Importance: Elevated risk of psychotic disorders in migrant groups is a pressing public mental health priority. Understanding the role of neighborhood factors, like migrant density, may further our understanding of the aetiology of psychotic disorders and highlight potential areas for public health intervention. Objective: To investigate whether migrants and their children living in areas of high own-region migrant density have lower risk of non-affective psychosis and consider whether generation status or visible minority status affect this relationship. Design: Cohort study using Swedish register data of all migrants and their children living in Sweden after 15 years old, born between 1982 and 1996. Setting: Nationwide study of all small area neighborhoods in Sweden. Participants: 468,223 migrants and children of migrants. Individuals were followed from age 15 or date of migration following their 15th birthday until a diagnosis of non-affective psychosis, emigration, death, or end of December 2016. Exposures: Neighborhood own-region migrant density and generation-specific own-region migrant density at cohort entry.Outcomes: ICD-10 diagnosis of non-affective psychosis (F20-29) as recorded in the National Patient Register between 1997 and 2016. Results: Overall, a 5% decrease in own-region migrant density was associated with an increased risk of non-affective psychosis (HR: 1.05; 95%CI 1.03-1.06), with similar effects for migrants (HR: 1.05; 95%CI 1.02-1.07) and children of migrants (HR: 1.03; 95%CI 1.01-1.06). A stronger effect was observed in probable visible minority migrants than non-visible minority migrants (HR: 1.07; 95%CI 1.04-1.11; HR: 0.99; 95%CI 0.94-1.04, respectively), with similar patterns for children of migrants. Conclusions and relevance: This study provides further evidence for the importance of the neighborhood environment in psychosis risk among migrants and their children. Stronger protective effects of migrant density, particularly for first generation migrants and those likely to be of visible minority status suggest this health inequality may arise be socially constructed.

Increased risk of fracture in patients with bipolar disorder: a nationwide cohort study

2016 ◽  
Vol 51 (9) ◽  
pp. 1331-1338 ◽  
Author(s):  
Chih-Chao Hsu ◽  
Yi-Chao Hsu ◽  
Kuang-Hsi Chang ◽  
Chang-Yin Lee ◽  
Lee-Won Chong ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
Risk Of Fracture ◽  
Increased Risk

scholarly journals The association of dry eye syndrome and psychiatric disorders: a nationwide population-based cohort study

2019 ◽  
Author(s):  
Chiao-Ying Liang ◽  
Wai-Man Cheang ◽  
Chun-Yuan Wang ◽  
Keng-Hung Lin ◽  
Li-Chen Wei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Cohort Study ◽  
Psychiatric Disorders ◽  
Dry Eye ◽  
Population Based ◽  
Dry Eye Syndrome ◽  
Psychiatric Disease ◽  
Neurotic Disorders ◽  
Increased Risk

Abstract Background Several previous studies reported a greater prevalence of dry eye syndrome (DES) among patients with psychiatric diseases. The aim of this study is to investigate the prevalence and risk factors of DES in patients with psychiatric disorders (PD) using nationwide population-based data in Taiwan. Methods This population-based cohort study retrospectively identified patients with PD from 1997 to 2011. The main outcome measures were the prevalence of DES in these patients and associated risk factors. Results A total of 75,650 patients with PD (3,665 in the DES cohort and 71,985 in the non-DES cohort) were included in the final analysis. The majority of patients in the DES group were women (72.6%). The mean age of patients in the DES cohort was 62.2 ± 14.9, which was significantly older than those in the non-DES group (50.9 ± 17.5). The patients with DES had a significantly greater likelihood of having dementia, bipolar disorder, depression, and neurotic disorders. Conditional regression analyses revealed that patients with dry eye disease were more likely to have schizophrenia (OR = 1.34), bipolar disorder (OR = 1.9), depression (OR = 1.54), and neurotic disorders (OR = 1.62). In addition, patients with DES were more likely to use 1st generation anti-psychotics (OR=1.28) and had a lower risk of using 2nd generation anti-psychotics (OR=0.64) Conclusion The study demonstrated that dry eye syndrome is associated with an increased risk of psychiatric disease, especially depression, bipolar disorder, and neurotic disorders, after adjusting for the comorbidities.

scholarly journals Chronic Periodontitis Is Associated with the Risk of Bipolar Disorder: A Population-Based Cohort Study

2020 ◽  
Vol 17 (10) ◽  
pp. 3466
Author(s):  
Yung-Kai Huang ◽  
Yu-Hsun Wang ◽  
Yu-Chao Chang
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
Chronic Periodontitis ◽  
Cox Regression ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Etiologic Factor ◽  
Research Database ◽  
Cox Regression Analysis ◽  
Increased Risk

Bipolar disorder (BD) is a psychiatric mood disturbance manifested by manic, hypomanic, or major depressive periods. Chronic inflammation was evidenced as an important etiologic factor of BD. Chronic periodontitis (CP) is an inflammatory disease triggered by bacterial products, leading to the destruction of periodontium. The relationship between BD and CP is of interest to investigate. Therefore, a nationwide population-based cohort study was used to investigate the risk of BD and CP exposure from 2001 to 2012. We identified 61,608 patients with CP from the Taiwanese National Health Insurance Research Database (NHIRD). The 123,216 controls were randomly captured and matched by age, sex, index year, and co-morbidities. The association between CP exposure and BD risk was examined by Cox proportional hazards regression models. In this study, 61,608 CP patients and 123,216 controls were followed up for 7.45 and 7.36 years, respectively. In total, 138 BD patients were identified in the CP cohort and 187 BD cases were found in the non-CP cohort. The incidence rate of BD was significantly higher in the CP cohort than in the non-CP cohort (adjusted HR: 1.46, 95% CI: 1.17–1.81) according to the multivariate Cox regression analysis. Females had a 1.47-fold increased risk (95% CI: 1.16–1.86) for BD compared to males. Taken together, CP may be associated with an increased risk of subsequent BD in Taiwan.

scholarly journals P0284RENAL FUNCTION AFTER DISCONTINUATION OF CHRONIC LITHIUM TREATMENT: FINDINGS FROM THE LISIE RETROSPECTIVE COHORT STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Filip Fransson ◽  
Ursula Werneke ◽  
Andreas Jonsson ◽  
Michael Ott
Keyword(s):  
Diabetes Mellitus ◽  
Bipolar Disorder ◽  
Renal Function ◽  
Cohort Study ◽  
Kidney Function ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lithium Treatment ◽  
Increased Risk ◽  
Annual Decline

Abstract Background and Aims Current guidelines consider lithium a first-line treatment for bipolar disorder to prevent relapse and suicide. Lithium, however, has renal adverse effects that can accumulate over decades of treatment. Studies have found a positive association between duration of lithium use and incidence of chronic kidney disease and prevalence of end stage renal disease. When the kidney function declines the treating clinician is presented with a choice of either continuing lithium, despite the risk of renal failure, or discontinuing lithium, despite an increased risk of relapse of the underlying affective disorder. One recent study showed that concerns about reduced renal function may account for 9% of reasons for lithium discontinuation. Yet it remains unknown, whether after lithium discontinuation, decline of renal function will continue unchanged, become less steep, or whether renal function can even improve. The aim of our study was to investigate the effect of lithium discontinuation on renal function. Method A retrospective mirror-image study, examining the decline of renal function five years before and after lithium discontinuation. Our study was part of LiSIE, a retrospective cohort study of patients with bipolar disorder, schizoaffective disorder and depression in the Swedish county of Norrbotten 1997 - 2017. We included all patients who had discontinued lithium between 1997 and 2013. We excluded patients who (a) had renal diseases possibly affecting renal function acutely (e.g. glomerulonephritis) or (b) used lithium less than 90% of the 5 years of the pre-mirror period. The patients provided informed verbal consent. In accordance with the ethical approval, deceased patients were also included. Patients were followed for 5 years after lithium discontinuation, until they initiated renal replacement therapy, restarted lithium treatment or died. To evaluate renal function, we calculated eGFR by the CKD-EPI -formula from all creatinine measurements taken during out- or in-patient care in the county of Norrbotten. We censored values for episodes of acute kidney injury or values not reflective of the underlying kidney function, such as in terminal cancer and cachexia. All data was manually validated in the medical records. A mixed effects model was fitted including eGFR as dependent variable. Age, hypertension and diabetes mellitus were included as fixed effects. Results Of 1340 patients with lithium treatment 579 patients had discontinued lithium. 172 patients (55.2% women, 44.8% men) with 5335 creatinine samples were eligible for inclusion. Mean age at discontinuation was 61.5 (min. 24.5 max. 91.3). Mean duration of lithium treatment was 15.8 (min. 4.5, max. 42.5) years. 19.2% of patients had diabetes and 48.9% had hypertension diagnosed before or during the study period. There was a statistically significant change in annual decline of renal function (p&lt;0.001), from -1.96 ml/min/year before (95% CI -2.22 to -1.70) and -0.22 ml/min/year (95% CI -0.50 to 0.07) after discontinuation. Diagnosed hypertension added -1.27 ml/min/year in decline of eGFR (p&lt;0.001). Diabetes mellitus did not affect the decline. Conclusion Mean annual decline of renal function is significantly steeper during lithium treatment than after discontinuation. However, decline still occurs. In patients with hypertension, the decline of renal function is accelerated irrespective of lithium discontinuation. The implications for renal function in individual patients considering lithium discontinuation remain unclear. The decision of whether to discontinue lithium depends on a careful trade-off of potential psychiatric risks against potential renal benefits.

P2548Lithium use and risk of out-of-hospital cardiac arrest in patients with bipolar disorder: A nationwide nested case-control study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D M Christensen ◽  
C A Barcella ◽  
T A Gerds ◽  
G H Gislason ◽  
C Torp-Pedersen ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cardiac Arrest ◽  
Case Control Study ◽  
Case Control ◽  
Increased Risk ◽  
History Of ◽  
Nested Case Control ◽  
Hospital Cardiac Arrest ◽  
Control Study ◽  
First Diagnosis

Abstract Background Lithium is a mood stabilizer widely used in the treatment of bipolar disorder. Lithium has been linked to malignant proarrhythmic electrocardiographic changes such as QT-prolongation, atrioventricular and sinoatrial block. However, evidence regarding the risk of cardiac arrest with lithium use is lacking. Purpose We investigated the risk of out-of-hospital cardiac arrest associated with lithium use among patients with bipolar disorder. Methods All out-of-hospital cardiac arrest cases from 2001 through 2014 of presumed cardiac cause with a history of bipolar disorder were identified from the nationwide Danish Cardiac Arrest Registry. We conducted a nested case-control study by matching all cardiac arrest cases with bipolar disorder on age, sex and time since first diagnosis of bipolar disorder with four controls from the general population who also had a history of bipolar disorder. Conditional logistic regression adjusted for comorbidities and concomitant pharmacotherapy was used to determine the association between lithium monotherapy and risk of out-of-hospital cardiac arrest compared to mood stabilizing monotherapy with valproate, lamotrigine and quetiapine, respectively. Exposure was defined as redeemed prescriptions for only one of either lithium, valproate, lamotrigine or quetiapine up to two months before index. Results The study population consisted of 1,410 patients with bipolar disorder, comprising 282 out-of-hospital cardiac arrest cases each matched with 4 controls. The median age was 69 years, 47.2% were male and the median time from first diagnosis of bipolar disorder was 7.25 years. Among cases, 59 (20.9%) were in lithium monotherapy and among controls the number was 299 (26.5%). For monotherapy with other mood stabilizers we observed the following distributions: quetiapine 18 (6.4%) cases and 51 (4.5%) controls, valproate 12 (4.3%) cases and 51 (4.5%) controls, and lamotrigine 15 (5.3%) cases and 64 (5.7%) controls. Lithium was not associated with an increased risk of OHCA compared to other mood stabilizing drugs: Hazard ratio (HR) 0.64 [95% confidence interval (CI) 0.31–1.33] (reference quetiapine), HR 0.56 [95% CI 0.25–1.24] (reference valproate) and HR 0.53 [95% CI 0.25–1.10] (reference lamotrigine). Figure 1 Conclusion Among patients with bipolar disorder, lithium was not associated with an increased risk of cardiac arrest compared to other mood stabilizing drugs. Further studies focusing on the cardiovascular safety of mood stabilizing drugs are warranted.

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