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Infections, Anti-infective Agents, and Risk of Deliberate Self-harm and Suicide in a Young Cohort: A Nationwide Study.

Abstract：

BACKGROUND:Evidence links infections to mental disorders and suicidal behavior. However, knowledge is sparse regarding less severe infections, anti-infective treatment, and deliberate self-harm. Using nationwide Danish longitudinal registers, we estimated associations between infections treated with anti-infective agents and infections requiring hospitalization with the risk of deliberate self-harm. METHODS:A total of 1.3 million people born between 1977 and 2002 were followed during the period from 1995 to 2013. In total, 15,042 individuals were recorded with deliberate self-harm (92% had been treated with anti-infective agents and 19% had been hospitalized for infections) and 114 died by suicide (64% had been treated with anti-infective agents and 13% had been hospitalized for infections). Hazard rate ratios were obtained while adjusting for age, gender, calendar period, education, hospitalizations with infections, prescribed anti-infective agents during childhood, parental mental disorders, and parental deliberate self-harm. RESULTS:Individuals with infections treated with anti-infective agents had an increased risk of deliberate self-harm with a hazard rate ratio of 1.80 (95% confidence interval = 1.68-1.91). The associations fitted a dose-response relationship (p < .001) and remained significant up to 5 years after last infection. An additive effect was found for individuals with an additional hospitalization for infections with an increased hazard rate ratio of 3.20 (95% confidence interval = 2.96-3.45) for deliberate self-harm. CONCLUSIONS:An increased risk of deliberate self-harm was found among individuals with infections treated with anti-infective agents in temporal and dose-response associations. These results add to the growing literature on a possible link between infections and the pathophysiological mechanisms of suicidal behavior.

journal_name

Biol Psychiatry

journal_title

Biological psychiatry

authors

Gjervig Hansen H,Köhler-Forsberg O,Petersen L,Nordentoft M,Postolache TT,Erlangsen A,Benros ME

doi

10.1016/j.biopsych.2018.11.008

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

744-751

issue

9

eissn

0006-3223

issn

1873-2402

pii

S0006-3223(18)32020-1

journal_volume

85

pub_type

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