肠道传染病后的精神疾病发病率:韩国一项全国性队列研究

Psychiatric Morbidity Following Intestinal Infectious Diseases: A Nationwide Cohort Study in South Korea.

作者信息

Kang Chaeyoon, Lee Seung Won, Jung Hohyun, Bae Youngoh

机构信息

Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.

出版信息

Stress Health. 2025 Oct;41(5):e70103. doi: 10.1002/smi.70103.

Abstract

Intestinal infectious diseases (IIDs), typically considered self-limiting, may exert lasting effects on mental health. This nationwide retrospective cohort study investigated the association between recurrent IID and the subsequent development of psychiatric disorders in South Korea. Using data from the National Health Insurance Service-National Sample Cohort (2002-2013), adults with three or more IID diagnoses were matched to controls without IID by age, sex, and health screening year. Eight psychiatric outcomes were examined: depressive disorder, bipolar disorder, anxiety disorder, obsessive-compulsive disorder (OCD), adjustment disorder, organic mental disorders, schizophrenia, and alcohol use disorder. Patients with recurrent IID showed significantly increased risks for depressive disorder (adjusted hazard ratio [aHR], 2.14), bipolar disorder (aHR, 1.80), anxiety disorder (aHR, 2.20), OCD (aHR, 3.84), adjustment disorder (aHR, 2.33), and organic mental disorders (aHR, 1.67). Psychiatric risks were disproportionately higher among younger individuals and male patients. A dose-dependent increase in psychiatric risk was observed with higher IID frequency. No significant associations were found for schizophrenia or alcohol use disorder in the overall analysis, although subgroup analyses revealed elevated risks with higher IID exposure. These findings suggest that recurrent IID may contribute to psychiatric morbidity via gut-brain axis disruption and systemic inflammation. Clinical attention to mental health following IID episodes, particularly in vulnerable populations, may be warranted.

摘要

肠道传染病(IIDs)通常被认为是自限性疾病,但可能对心理健康产生持久影响。这项全国性回顾性队列研究调查了韩国复发性IIDs与随后发生精神障碍之间的关联。利用国民健康保险服务-全国样本队列(2002 - 2013年)的数据,将有三次或更多次IIDs诊断的成年人按年龄、性别和健康筛查年份与无IIDs的对照组进行匹配。研究了八种精神疾病结局:抑郁症、双相情感障碍、焦虑症、强迫症(OCD)、适应障碍、器质性精神障碍、精神分裂症和酒精使用障碍。复发性IIDs患者患抑郁症(调整后风险比[aHR],2.14)、双相情感障碍(aHR,1.80)、焦虑症(aHR,2.20)、OCD(aHR,3.84)、适应障碍(aHR,2.33)和器质性精神障碍(aHR,1.67)的风险显著增加。年轻个体和男性患者的精神疾病风险尤其更高。随着IIDs发作频率的增加,观察到精神疾病风险呈剂量依赖性增加。在总体分析中,未发现精神分裂症或酒精使用障碍有显著关联,尽管亚组分析显示IIDs暴露增加会导致风险升高。这些发现表明,复发性IIDs可能通过肠脑轴破坏和全身炎症导致精神疾病发病率上升。IID发作后,尤其是对弱势群体,可能需要临床关注其心理健康。

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