Infections as a Risk Factor for and Prognostic Factor After Substance-Induced Psychoses
Abstract
Objective:
Methods:
Results:
Conclusions:
Methods
Population
Substance-Induced Psychosis
Infections
Schizophrenia
Potential Confounders
Statistical Analysis
Results
Characteristic | N | % |
---|---|---|
Male | 1,158,251 | 51.3 |
Alcohol or substance use disordera | 67,046 | 3.0 |
Highest paternal level of education | ||
Ninth or 10th grade | 429,852 | 19.0 |
High school or vocational education | 1,167,151 | 51.7 |
Bachelor’s degree or equivalent | 294,030 | 13.0 |
Master’s-level university degree | 261,217 | 11.6 |
Not registered in Statistics Denmark | 104,529 | 4.6 |
Highest maternal level of education | ||
Ninth or 10th grade | 401,047 | 17.8 |
High school or vocational education | 982,271 | 43.5 |
Bachelor’s degree or equivalent | 571,159 | 25.9 |
Master’s-level university degree | 228,349 | 10.1 |
Not registered in Statistics Denmark | 73,953 | 3.3 |
Paternal substance use disorder | 221,283 | 9.8 |
Maternal substance use disorder | 111,161 | 4.9 |
Paternal psychotic disorder | 22,151 | 1.0 |
Maternal psychotic disorder | 21,879 | 1.0 |
Other paternal psychiatric disorder | 186,267 | 8.3 |
Other maternal psychiatric disorder | 275,011 | 12.2 |
Infections as Predictors of Substance-Induced Psychosis
Model 1 | Model 2 | |||||
---|---|---|---|---|---|---|
Infection | Hazard Ratio | 95% CI | p | Hazard Ratio | 95% CI | p |
Any infection | 1.66 | 1.56–1.76 | <0.001 | 1.30 | 1.22–1.39 | <0.001 |
Hepatitis | 7.70 | 5.57–10.64 | <0.001 | 3.42 | 2.47–4.74 | <0.001 |
Sepsis | 1.66 | 1.32–2.09 | <0.001 | 1.40 | 1.11–1.76 | 0.004 |
Gastrointestinal infection | 1.39 | 1.26–1.53 | <0.001 | 1.13 | 1.02–1.24 | 0.02 |
Skin infection | 1.69 | 1.52–1.87 | <0.001 | 1.31 | 1.18–1.46 | <0.001 |
Respiratory infection | 1.42 | 1.31–1.53 | <0.001 | 1.11 | 1.03–1.20 | 0.006 |
Urogenital infection | 2.30 | 1.91–2.76 | <0.001 | 1.65 | 1.39–1.99 | <0.001 |
CNS infection | 1.19 | 0.89–1.61 | 0.25 | 1.00 | 0.74–1.34 | 0.99 |
Other infections | 1.73 | 1.57–1.91 | <0.001 | 1.39 | 1.26–1.53 | <0.001 |
Infections and Specific Types of Substance-Induced Psychosis
Infections as Predictors of Conversion From Substance-Induced Psychosis to Schizophrenia
Model 1 | Model 2 | Model 3 | |||||||
---|---|---|---|---|---|---|---|---|---|
Infection and Timing Relative to SIP | Hazard Ratio | 95% CI | p | Hazard Ratio | 95% CI | p | Hazard Ratio | 95% CI | p |
Any infection prior to SIP | 0.95 | 0.83–1.09 | 0.48 | 0.96 | 0.83–1.10 | 0.55 | |||
Any infection after SIP | 0.88 | 0.66–1.16 | 0.36 | 0.88 | 0.66–1.17 | 0.38 | 0.88 | 0.66–1.18 | 0.40 |
Hepatitis after SIP | 1.89 | 1.09–3.30 | 0.02 | 1.89 | 1.09–3.30 | 0.02 | 1.87 | 1.07–3.26 | 0.03 |
Sepsis after SIP | 0.74 | 0.19–5.24 | 0.76 | 0.74 | 0.10–5.30 | 0.77 | 0.66 | 0.09–4.70 | 0.68 |
Gastrointestinal infection after SIP | 1.10 | 0.60–2.01 | 0.76 | 1.11 | 0.61–2.03 | 0.73 | 1.14 | 0.62–2.08 | 0.67 |
Skin infection after SIP | 0.93 | 0.60–1.44 | 0.74 | 0.93 | 0.60–1.45 | 0.75 | 0.94 | 0.60–1.46 | 0.78 |
Respiratory infection after SIP | 0.72 | 0.37–1.39 | 0.32 | 0.72 | 0.37–1.39 | 0.33 | 0.72 | 0.37–1.41 | 0.34 |
Urogenital infection after SIP | 0.67 | 0.25–1.80 | 0.43 | 0.67 | 0.25–1.81 | 0.43 | 0.67 | 0.25–1.81 | 0.43 |
CNS infection after SIP | Inestimable | Inestimable | Inestimable | ||||||
Other infections after SIP | 0.92 | 0.52–1.64 | 0.77 | 0.93 | 0.52–1.65 | 0.79 | 0.94 | 0.53–1.68 | 0.85 |
Discussion
The Association Between Infections and Substance-Induced Psychosis
The Association Between Infections and Specific Types of Substance-Induced Psychosis
The Association Between Infections and Conversion From Substance-Induced Psychosis to Schizophrenia
Implications
Strengths and Limitations
Conclusions
Supplementary Material
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