Beyond Urinary Tract Infections (UTIs) and Delirium: A Systematic Review of UTIs and Neuropsychiatric Disorders

@article{Chae2015BeyondUT,
  title={Beyond Urinary Tract Infections (UTIs) and Delirium: A Systematic Review of UTIs and Neuropsychiatric Disorders},
  author={Jung Hee Chae and Brian J. Miller},
  journal={Journal of Psychiatric Practice},
  year={2015},
  volume={21},
  pages={402–411}
}
  • J. ChaeB. Miller
  • Published 1 November 2015
  • Psychology, Medicine
  • Journal of Psychiatric Practice
Urinary tract infections (UTIs) are among the most common bacterial infections. [] Key Method We identified studies by searching PubMed, PsycInfo, and Web of Knowledge, and the reference lists of identified studies and review papers. Seventeen publications met the inclusion criteria. The primary findings were: (1) 88% of publications reported a positive association between UTIs and neuropsychiatric disorders; (2) 47% reported that the clinical course of a neuropsychiatric disorder may be precipitated or…

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Interleukin-6 mediates delirium-like phenotypes in a murine model of urinary tract infection

Evidence for a role for IL-6 in mediating delirium-like phenotypes in a mouse model of UTI is provided, providing pre-clinical justification for clinical investigations of IL- 6 inhibitors to treat UTI-induced delIRium.

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It is found that correctly diagnosing UTIs and prescribing antibiotics for UTIs is a challenge that needs major improvement, especially during out-of-hours GP care.

Psychosis as an adverse effect of antibiotics

17β-estradiol ameliorates delirium-like phenotypes in a murine model of urinary tract infection

It is demonstrated that a beneficial role for 17β-estradiol in ameliorating acute UTI-induced structural and functional delirium-like phenotypes is demonstrated, providing pre-clinical justification for 17 β-mostradiol as a therapeutic target to amelIORate deliria following UTI.

References

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Urinary tract infection in very old women is associated with delirium

A large proportion of very old women with UTI suffered from delirium which might indicate that UTI is a common cause ofDelirium, and more focus is needed on detecting, preventing and treating UTI to avoid unnecessary suffering among old women.

Urinary tract infections in acute psychosis.

It is suggested that infections appear relevant to the etiopathophysiology of relapse and increased premature mortality risk in the psychoses, and the potential importance of monitoring for comorbid UTI in relevant patient populations is highlighted.

Antibiotic-Associated Psychosis During Treatment of Urinary Tract Infections: A Systematic Review

It is suggested that acute psychosis is a potential adverse effect of antibiotic treatment of UTI, although the mechanism(s) underlying this association remains unclear.

Prevalence of Delirium and Urinary Tract Infection in a Psychogeriatric Unit

Clinicians need to have a high index of suspicion relative to the presence of UTI in the elderly, especially with pre- existing cognitive impairment, since it can precipitate delirium.

Delirium, a Symptom of UTI in the Elderly: Fact or Fable? A Systematic Review*

Though the studies examined conclude that there is an association between UTI and delirium, all of them had significant methodological flaws that likely led to biased results and it is difficult to ascertain the degree to which urinary tract infections cause Delirium.

A prevalence study of urinary tract infections in acute relapse of schizophrenia.

The finding of an association between an increased prevalence of UTI and acute psychotic relapse warrants replication in other samples, and highlights the potential importance of monitoring for comorbid UTI in acutely relapsed patients with schizophrenia.

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Limited interexpert agreement seemed to result from difficulty in diagnosing patients who had no local symptoms but acute comorbid conditions with potential symptom crossover, and delirium was most closely associated with UTI.

Potentially preventable complications of urinary tract infections, pressure areas, pneumonia, and delirium in hospitalised dementia patients: retrospective cohort study

The highest rates and highest relative risk for dementia patients compared with non-dementia patients, in both medical and surgical populations, were found in four common complications: urinary tract infections, pressure areas, pneumonia and delirium.

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