Abstract
Background
Previous studies have shown an association between depression and susceptibility to infection in adults. However, few studies have investigated the association between treatment-resistant depression (TRD) and severe infections in adolescents and young adults.
Methods
This study included adolescents (12–19 years of age) and young adults (20–29 years of age) who were diagnosed with major depressive disorder (MDD, including 6958 cases of TRD and 27832 cases of antidepressant-responsive depression [ARPD]), from the Taiwan National Health Insurance Research Database (NHIRD), from 2001 to 2010. The TRD and ARPD groups were further matched (4:1) by chronological age, age at diagnosis of depression, sex, residence, and family income. The primary outcomes were severe bacterial infections (SBI) and septicemia. Cox regression analysis was conducted to identify the risk of hospitalization due to SBI or septicemia during the follow-up period.
Results
Compared with controls, the ARPD group had increased risks of SBI (hazard ratio [HR] with 95% confidence interval [CI]: 3.90, 2.73–5.57) and septicemia (HR, 95% CI: 2.56, 1.34–4.91). Notably, the risks of SBI and septicemia appeared to be further elevated in the TRD group. The TRD group exhibited higher incidences of SBI (HR, 95% CI: 6.99, 4.73–10.34) and septicemia (HR, 95% CI: 2.85, 1.28–6.36) than the control group.
Conclusions
Adolescents and young adults with TRD had 6.99-fold and 3.90-fold increased risks of SBI and septicemia compared to individuals without MDD, respectively. Therefore, healthcare providers need to be vigilant when monitoring and implementing preventive measures in this population.