Higher frequency of psychiatric morbidity in patients with bacterial infection of the skin and subcutaneous tissue versus cutaneous neoplasms: results from a nationally representative sample from the United States.

BACKGROUND

Poor hygiene and nutrition and resultant compromised immune status in some psychiatric patients can increase susceptibility to bacterial skin infections.

OBJECTIVE

We examined the frequency of ICD9-CM psychiatric disorders (codes 290-319) in bacterial skin infections (ICD9-CM codes 680-686) (N  =  18,734) versus malignant and benign cutaneous neoplasms (ICD9-CM codes 172, 173, 232, 216) (N  =  8,376), conditions that would be expected to cause psychological distress for the patient.

METHODS

Logistic regression analysis was conducted controlling for age, sex, race, diabetes, obesity, and the use of antineoplastic and immunosuppressant medications.

RESULTS

Skin infections were more commonly (odds ratio  =  3.03, 95% CI 1.58-5.82) associated with a psychiatric disorder; the most frequent diagnoses were substance dependence and abuse (19.5%), depressive disorder (19.0%), attention-deficit disorder (14.4%), and anxiety disorders (11.6%).

CONCLUSION

In contrast to cutaneous neoplasms, bacterial skin infections were three times as likely to be associated with a psychiatric disorder. Psychiatric comorbidity should be ruled out as a factor in patients with intractable skin infections.