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Risk for Life-Threatening Infections Greater With Stress-Related Disorders

Hazard ratios higher with younger age at diagnosis of stress-related disorders, psychiatric comorbidity

THURSDAY, Oct. 24, 2019 (HealthDay News) — Stress-related disorders are associated with an increased risk for life-threatening infections, according to a study published online Oct. 23 in The BMJ.

Huan Song, M.D., Ph.D., from the University of Iceland in Reykjavik, and colleagues examined whether severe psychiatric reactions to trauma and other adversities correlate with subsequent risk for life-threatening infections using data from 144,919 individuals with stress-related disorders (identified from 1987 to 2013), 184,612 matched full siblings, and 1,449,190 matched individuals from the general population.

The researchers found that the incidence of life-threatening infections was 2.9, 1.7, and 1.3 per 1,000 person-years in individuals with a stress-related disorder, siblings without a diagnosis, and matched individuals without a diagnosis, respectively. Individuals with a diagnosis of a stress-related disorder had an increased risk for life-threatening infections compared with full siblings without a diagnosis (hazard ratios, 1.47 for any stress-related disorder; 1.92 for posttraumatic stress disorder [PTSD]); in the population-based analysis, the corresponding estimates were similar (hazard ratios, 1.58 for any stress-related disorder and 1.95 for PTSD). There were correlations for stress-related disorders with all studied life-threatening infections. Higher hazard ratios were seen with younger age at diagnosis of a stress-related disorder and presence of psychiatric comorbidity, while hazard ratios were attenuated with use of selective serotonin reuptake inhibitors in the first year after diagnosis.

“Despite a relatively low absolute risk, the high mortality from life-threatening infections calls for increased clinical awareness among health professionals caring for patients with stress-related disorders,” the authors write.

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