Infection, antibiotic use linked to manic episodes in psychiatric patients

Although researchers say their recent study does not establish a cause-and-effect association, there appears to be a link.

By Stephen Feller

BALTIMORE, July 20 (UPI) -- Changes to the collection of bacteria in the gut have been linked to a range of health effects, and now researchers think bacterial infections or antibiotic treatment for infections could play a role in some psychiatric episodes.

While not saying one causes the other, researchers at Johns Hopkins University report a link to changes in the microbiome due to an infection or antibiotic treatment could play a role in psychiatric symptoms and disorders.


Previous studies have shown changes to the microbiome can alter the behavior of animals, with the new research suggesting the link between the brain and gut is significant enough that changes to one affect the other.

For the study, published in the journal Bipolar Disorders, the researchers reviewed medical records for 368 patients admitted to the Sheppard Pratt psychiatric hospital. Of the participants, 234 were hospitalized for mania, 101 were hospitalized for bipolar disorder, 70 for depression and 197 for schizophrenia, all of whom were compared to 555 healthy patients.

Among patients hospitalized for mania and overactivity linked to bipolar disorder, 7.7 percent were being treated with antibiotics, compared to 1.3 percent of controls. Of other conditions, 3 percent of those hospitalized for schizophrenia, 4 percent for bipolar depression and 2.9 percent of those with depression were also on antibiotics when hospitalized for heightened symptoms.


While researchers say are unsure of the link, either the potential for inflammation from an infection or gut biome changes from antibiotics, or both, may be playing a role in heightened symptoms of psychiatric disorders.

If an actual link is established, they say, more attention to healthcare -- or even just care without use of antibiotics -- may be necessary to better manage psychiatric conditions.

"More research is needed, but ours suggests that if we can prevent infections and minimize antibiotic treatment in people with mental illness, then we might be able to prevent the occurrence of manic episodes," Dr. Robert Yolken, a professor of neurovirology in pediatrics at the Johns Hopkins University School of Medicine, said in a press release. "This means we should focus on good-quality health care and infection prevention methods for this susceptible population and pay extra attention to such things as flu shots, safe sex practices, and urinary tract infections in female patients."

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