Pneumococcal disease risk increased in mental health patients

By Mark Cowen, Senior medwireNews Reporter

Patients with severe mental illness are at increased risk for pneumococcal disease, results from a UK study suggest.

Michael Goldacre and Olena Seminog, both from the University of Oxford, found that patients hospitalized with schizophrenia, bipolar disorder, depression, or anxiety were more than twice as likely to develop pneumococcal disease (lobar pneumonia, pneumococcal pneumonia, pneumococcal septicemia, or meningitis) as other patients.

"If our findings are replicated elsewhere, there would be a case for considering routine pneumococcal immunisation for people with severe mental illness," comment the researchers in Thorax.

The team assessed data on pneumococcal disease rates in more than 367,000 patients hospitalized for schizophrenia, bipolar disorder, depression, or anxiety between 1999 and 2011.

Compared with other hospitalized patients, those with schizophrenia, bipolar disorder, depression, and anxiety were a respective 2.3, 2.3, 2.1, and 2.2 times more likely to develop pneumococcal disease.

The increased risk for pneumococcal disease associated with severe mental illness was even stronger among patients aged less than 60 years. Indeed, schizophrenia, bipolar disorder, depression, and anxiety patients in this age group were a respective 2.8, 2.6, 2.9, and 2.8 times more likely to develop pneumococcal disease than other hospitalized patients.

The team also notes that the increased risk persisted for at least 6 years after discharge, suggesting that it was not associated with the event of hospitalization.

Goldacre and Seminog conclude: "Severe mental illness is a risk factor for lobar pneumonia, pneumococcal pneumonia, pneumococcal septicaemia and meningitis."

They add: "Possible explanations for the elevated risk include factors relating to lifestyle and health-risk activities."

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