Infectious, atopic and inflammatory diseases, childhood adversities and familial aggregation are independently associated with the risk for mental disorders: Results from a large Swiss epidemiological study

Table 1 Groups of mental disorders and risk factors in the PsyCoLaus study: Frequencies and crude odds ratios (with 95%CI), overall and by sex

	n (%)	Education level low	Education level medium	Education level high	Familial aggregation6	Trauma below age of 10	Childhood adversities7	Streptococcal diseases8	MMR	Peptic ulcer/gastritis	Irritable bowel syndrome	Atopic diseases	Acne	Psoriasis	Urinary tract infections9
Total n (%)
All	3720 (100.0)	1965 (53.4)	916 (24.9)	798 (21.7)	2071 (55.7)	160 (4.3)	1013 (27.2)	230 (6.2)	3033 (86.7)	317 (6.5)	187 (3.8)	2129 (43.8)	474 (9.7)	220 (4.5)	844 (22.7)
Males	1750 (47.0)	888 (51.3)	366 (21.1)	477 (27.6)	876 (50.1)	45 (2.6)	417 (23.8)	87 (5.0)	1353 (83.2)	159 (7.0)	52 (2.3)	895 (39.6)	191 (8.4)	108 (4.8)	86 (4.9)
Females	1970 (53.0)	1077 (55.3)	550 (28.2)	321 (16.5)	1195 (60.7)	115 (5.8)	596 (30.3)	143 (7.3)	1226 (89.6)	158 (6.1)	135 (5.2)	1234 (47.4)	283 (10.9)	112 (4.3)	758 (38.5)
Odds ratios
Neurodevelop- mental disorders1
All	308 (8.3)	1 (ref)	1.17 (0.89-1.55)	0.94 (0.69-1.29)	1.75 (1.26-2.42)	1.93 (1.22-3.05)	2.93 (2.31-3.71)	1.67 (1.11-2.50)	1.18 (0.83-1.67)	1.68 (1.14-2.49)	1.74 (1.07-2.83)	0.98 (0.78-1.24)	0.87 (0.59-1.29)	1.07 (0.63-1.80)	1.13 (0.86-1.48)
Males	189 (10.8)	1 (ref)	1.39 (0.96-2.00)	0.85 (0.58-1.24)	1.98 (1.27-3.10)	1.28 (0.53-3.06)	3.10 (2.27-4.23)	2.65 (1.57-4.48)	1.35 (0.87-2.08)	1.52 (0.89-2.57)	2.18 (1.03-4.61)	1.15 (0.85-1.56)	0.88 (0.50-1.53)	1.09 (0.57-2.08)	1.36 (0.73-2.56)
Females	119 (6.0)	1 (ref)	1.03 (0.67-1.57)	0.93 (0.54-1.58)	1.75 (1.08-2.85)	2.98 (1.72-5.12)	3.22 (2.21-4.69)	1.05 (0.52-2.11)	1.13 (0.63-2.04)	1.94 (1.08-3.49)	1.86 (0.97-3.58)	0.89 (0.62-1.30)	0.97 (0.55-1.72)	0.93 (0.37-2.35)	1.94 (1.34-2.82)
Early anxiety disorders2
All	951 (25.6)	1 (ref)	0.98 (0.82-1.17)	0.93 (0.77-1.12)	2.75 (2.36-3.21)	1.96 (1.41-2.71)	1.85 (1.58-2.17)	1.51 (1.13-2.00)	1.43 (1.12-1.81)	1.33 (1.01-1.76)	2.42 (1.74-3.37)	1.23 (1.06-1.43)	1.32 (1.05-1.66)	1.41 (1.03-1.94)	1.90 (1.61-2.24)
Males	327 (18.7)	1 (ref)	1.03 (0.76-1.41)	1.06 (0.80-1.41)	2.48 (1.93-3.20)	2.01 (1.06-3.82)	2.01 (1.55-2.61)	1.71 (1.05-2.78)	1.27 (0.89-1.80)	1.75 (1.15-2.66)	2.84 (1.53-5.27)	1.03 (0.81-1.31)	1.59 (1.08-2.32)	2.22 (1.42-3.48)	1.25 (0.74-2.11)
Females	624 (31.7)	1 (ref)	0.90 (0.72-1.13)	1.01 (0.77-1.32)	2.76 (2.26-3.36)	1.65 (1.13-2.42)	1.65 (1.35-2.02)	1.29 (0.91-1.84)	1.35 (0.96-1.88)	1.11 (0.77-1.61)	1.97 (1.33-2.92)	1.25 (1.03-1.51)	1.11 (0.83-1.47)	1.01 (0.64-1.59)	1.51 (1.24-1.83)
Late anxiety disorders3
All	554 (14.9)	1 (ref)	0.96 (0.77-1.20)	0.82 (0.64-1.04)	2.15 (1.67-2.76)	1.64 (1.12-2.42)	1.92 (1.59-2.32)	1.38 (0.98-1.94)	1.44 (1.07-1.95)	1.66 (1.21-2.27)	2.30 (1.59-3.32)	1.34 (1.12-1.61)	1.13 (0.85-1.49)	1.13 (0.75-1.69)	1.49 (1.22-1.82)
Males	200 (11.4)	1 (ref)	1.14 (0.78-1.67)	1.22 (0.87-1.72)	1.96 (1.24-3.08)	0.97 (0.38-2.48)	1.60 (1.16-2.20)	1.01 (0.51-1.99)	1.03 (0.68-1.56)	1.32 (0.77-2.25)	2.04 (0.97-4.31)	1.19 (0.89-1.61)	1.56 (0.99-2.46)	0.70 (0.33-1.47)	2.68 (1.60-4.49)
Females	354 (18.0)	1 (ref)	0.84 (0.65-1.11)	0.64 (0.45-0.92)	2.06 (1.53-2.79)	1.67 (1.08-2.57)	2.02 (1.59-2.55)	1.47 (0.98-2.20)	1.75 (1.11-2.75)	1.93 (1.29-2.86)	2.14 (1.39-3.29)	1.35 (1.07-1.69)	0.88 (0.61-1.27)	1.56 (0.95-2.56)	1.06 (0.83-1.34)
Mood disorders4
All	1765 (47.4)	1 (ref)	1.21 (1.03-1.41)	0.99 (0.84-1.16)	2.14 (1.87-2.45)	1.90 (1.37-2.63)	2.07 (1.79-2.40)	1.05 (0.80-1.38)	1.18 (0.97-1.44)	1.71 (1.32-2.22)	2.31 (1.63-3.26)	1.27 (1.11-1.44)	1.29 (1.05-1.59)	1.45 (1.07-1.96)	2.19 (1.87-2.56)
Males	628 (35.9)	1 (ref)	1.43 (1.11-1.84)	1.26 (1.00-1.59)	1.93 (1.57-2.37)	1.91 (1.05-3.44)	1.85 (1.48-2.31)	1.01 (0.51-1.69)	1.15 (0.88-1.52)	1.70 (1.17-2.47)	1.65 (0.91-3.00)	1.29 (1.06-1.57)	1.76 (1.27-2.45)	1.38 (0.91-2.09)	2.04 (1.32-3.14)
Females	1137 (57.7)	1 (ref)	1.00 (0.82-1.24)	1.02 (0.79-1.31)	2.08 (1.73-2.50)	1.52 (1.02-2.27)	2.12 (1.72-2.60)	1.01 (0.72-1.43)	0.93 (0.70-1.26)	1.83 (1.25-2.69)	2.25 (1.44-3.52)	1.09 (0.91-1.30)	0.93 (0.71-1.23)	1.79 (1.12-2.85)	1.47 (1.22-1.77)
Substance abuse/ dependence5
All	576 (15.5)	1 (ref)	0.77 (0.61-0.96)	0.89 (0.71-1.12)	2.10 (1.62-2.72)	1.22 (0.81-1.84)	1.82 (1.51-2.19)	0.89 (0.56-1.40)	0.90 (0.69-1.17)	1.55 (1.13-2.12)	1.26 (0.83-1.92)	0.97 (0.81-1.16)	1.17 (0.89-1.54)	1.42 (0.98-2.06)	0.78 (0.61-0.98)
Males	429 (24.5)	1 (ref)	0.82 (0.62-1.09)	0.66 (0.51-0.87)	2.65 (1.87-3.75)	1.00 (0.50-1.98)	1.94 (1.52-2.47)	0.98 (0.59-1.62)	0.98 (0.73-1.33)	1.62 (1.09-2.41)	1.79 (0.96-3.35)	1.12 (0.90-1.40)	1.64 (1.15-2.33)	1.24 (0.78-1.97)	1.36 (0.84-2.18)
Females	147 (7.5)	1 (ref)	0.80 (0.53-1.21)	1.00 (0.63-1.59)	2.11 (1.35-3.29)	2.48 (1.46-4.24)	2.60 (1.85-3.65)	0.82 (0.41-1.65)	1.58 (0.82-3.06)	1.53 (0.86-2.74)	1.64 (0.88-3.07)	1.06 (0.75-1.48)	0.89 (0.52-1.53)	1.66 (0.84-3.28)	1.41 (1.01-1.98)

¹Tics, attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder;

²Separation anxiety disorder, overanxious disorder, specific phobias (animals), social phobia;

³Generalized anxiety disorder, panic, agoraphobia, specific phobias (excl. animals);

⁴Major depression disorder, dysthymia, bipolar disorders;

⁵Alcohol, cannabis, other illicit drugs abuse/dependence;

⁶Overall figures; Ns relating to each subgroup of mental disorders: 382 (neurodevelopmental), 1110 (early anxiety), 386 (late anxiety), 1446 (mood), 349 (substances); OR’s were based on subgroup specific information;

⁷Interparental violence, fear of maltreatment by parents, growing up in a children’s home, unhappy childhood;

⁸Tonsillitis, scarlet fever, rheumatic fever. MMR: Measles/mumps/rubella;

⁹Cystitis, pyelitis, pyelonephritis, other nephritis, urethritis, prostatitis.

Table 2 Mental disorders regressed on infectious, atopic and inflammatory diseases, odds-ratios and 95%CI derived from logistic regression models

	Model 1 Neurodevelopmental disorders	Model 2 Early anxiety disorders	Model 3 Late anxiety disorders	Model 4 Mood disorders	Model 5 Substance abuse/ dependence
Sex	0.38 (0.27-0.52)	1.60 (1.33-1.94)	1.50 (1.19-1.87)	2.05 (1.74-2.41)	0.19 (0.14-0.24)
Education level
Low	1 (ref)	1 (ref)	1 (ref)	1 (ref)	1 (ref)
Medium	0.91 (0.66-1.24)	1.24 (1.01-1.52)	1.11 (0.87-1.41)	0.86 (0.72-1.04)	1.19 (0.92-1.54)
High	1.10 (0.78-1.56)	1.08 (0.87-1.34)	1.07 (0.83-1.39)	0.88 (0.72-1.06)	1.27 (0.98-1.66)
Familial aggregation of CMD	1.55 (1.07-2.23)	2.54 (2.14-3.01)	1.75 (1.34-2.29)	1.77 (1.52-2.06)	2.12 (1.59-2.82)
Trauma below age of 10	1.43 (0.84-2.44)	1.07 (0.73-1.57)	1.12 (0.73-1.71)	1.11 (0.76-1.62)	1.36 (0.84-2.20)
Childhood adversities	2.74 (2.09-3.60)	1.51 (1.25-1.81)	1.89 (1.53-2.33)	1.87 (1.57-2.23)	1.81 (1.45-2.27)
Streptococcal infections	1.29 (0.79-2.10)	1.11 (0.80-1.55)	1.22 (0.84-1.78)	0.80 (0.59-1.10)	0.80 (0.51-1.25)
Mumps, measles, rubella	1.37 (0.91-2.06)	1.36 (1.04-1.77)	1.33 (0.97-1.83)	1.07 (0.86-1.34)	1.15 (0.85-1.54)
Peptic ulcer/gastritis	1.72 (1.11-2.68)	1.23 (0.89-1.71)	1.47 (1.03-2.11)	1.74 (1.27-2.39)	1.58 (1.09-2.29)
Irritable bowel syndrome	1.30 (0.71-2.36)	1.81 (1.24-2.64)	1.74 (1.15-2.62)	1.87 (1.26-2.79)	1.70 (1.06-2.73)
Atopic diseases	0.95 (0.73-1.25)	1.11 (0.94-1.31)	1.24 (1.01-1.51)	1.06 (0.91-1.24)	1.02 (0.83-1.26)
Acne	0.83 (0.53-1.30)	1.10 (0.85-1.43)	1.02 (0.74-1.39)	1.23 (0.97-1.57)	1.27 (0.92-1.76)
Psoriasis	1.22 (0.69-2.16)	1.45 (0.99-2.11)	1.05 (0.66-1.69)	1.59 (1.11-2.28)	1.41 (0.91-2.19)
Urinary tract infections	1.51 (1.06-2.14)	1.37 (1.12-1.67)	1.06 (0.83-1.35)	1.49 (1.22-1.80)	1.20 (0.88-1.64)

CMD: Common mental disorders.

Table 3 Mental disorders regressed on infectious, atopic and inflammatory diseases, odds-ratios and 95%CIs derived from logistic regression models with nested effects

		Model 1 Neurodevelopmental disorders	Model 2 Early anxiety disorders	Model 3 Late anxiety disorders	Model 4 Mood disorders	Model 5 Substance abuse/ dependence
Sex		0.41 (0.23-0.72)	0.79 (0.54-1.15)	1.08 (0.68-1.69)	1.56 (1.08-2.26)	0.34 (0.21-0.54)
Education level
Low		1 (ref)	1 (ref)	1 (ref)	1 (ref)	1 (ref)
Medium		1.09 (0.79-1.49)	0.79 (0.65-0.98)	0.89 (0.70-1.13)	1.15 (0.96-1.38)	0.83 (0.64-1.08)
High		0.88 (0.62-1.25)	0.91 (0.73-1.14)	0.92 (0.71-1.20)	1.12 (0.92-1.36)	0.77 (0.59-1.01)
Familial aggregation of CMD		1.53 (1.06-2.21)	2.53 (2.14-3.00)	1.78 (1.36-2.33)	1.77 (1.52-2.06)	2.14 (1.60-2.86)
Trauma below age of 10		1.47 (0.86-2.50)	1.08 (0.73-1.58)	1.11 (0.73-1.71)	1.12 (0.76-1.64)	1.40 (0.86-2.27)
Childhood adversities		2.78 (2.12-3.65)	1.52 (1.26-1.83)	1.91 (1.55-2.36)	1.89 (1.59-2.25)	1.83 (1.46-2.29)
Streptococcal infections	Women nested	0.69 (0.29-1.67)	1.15 (0.76-1.73)	1.32 (0.84-2.07)	0.91 (0.60-1.36)	0.87 (0.42-1.82)
	Men nested	1.98 (1.08-3.66)	1.08 (0.60-1.92)	1.04 (0.51-2.09)	0.67 (0.40-1.12)	0.78 (0.44-1.39)
Mumps, measles, rubella	Women nested	1.16 (0.58-2.32)	1.46 (1.01-2.10)	1.81 (1.12-2.90)	0.97 (0.70-1.35)	1.62 (0.79-3.29)
	Men nested	1.47 (0.88-2.45)	1.29 (0.88-1.91)	0.96 (0.62-1.49)	1.12 (0.83-1.52)	1.04 (0.74-1.46)
Peptic ulcer/gastritis	Women nested	1.72 (0.88-3.34)	0.97 (0.63-1.49)	1.60 (1.02-2.51)	1.58 (1.02-2.46)	1.19 (0.61-2.35)
	Men nested	1.95 (1.08-3.53)	1.85 (1.13-3.05)	1.25 (0.67-2.35)	1.98 (1.26-3.09)	1.88 (1.18-2.99)
Irritable bowel syndrome	Women nested	1.23 (0.56-2.70)	1.48 (0.95-2.30)	1.60 (0.99-2.57)	2.25 (1.35-3.76)	1.63 (0.84-3.16)
	Men nested	1.74 (0.70-4.36)	3.15 (1.58-6.28)	1.97 (0.86-2.48)	1.33 (0.67-2.62)	1.80 (0.90-3.61)
Atopic diseases	Women nested	0.74 (0.48-1.12)	1.19 (0.96-1.47)	1.28 (0.99-1.66)	0.97 (0.79-1.18)	1.02 (0.69-1.49)
	Men nested	1.14 (0.80-1.61)	1.02 (0.77-1.34)	1.19 (0.86-1.66)	1.22 (0.97-1.53)	1.05 (0.81-1.35)
Acne	Women nested	0.75 (0.39-1.47)	0.94 (0.68-1.31)	0.82 (0.55-1.23)	0.90 (0.66-1.24)	0.74 (0.40-1.37)
	Men nested	0.92 (0.50-1.67)	1.47 (0.96-2.25)	1.52 (0.92-2.51)	1.96 (1.35-2.85)	1.74 (1.17-2.59)
Psoriasis	Women nested	0.84 (0.29-2.43)	1.05 (0.60-1.82)	1.48 (0.83-2.66)	2.02 (1.14-3.58)	1.70 (0.77-3.73)
	Men nested	1.44 (0.73-2.86)	2.02 (1.20-3.39)	0.60 (0.25-1.42)	1.33 (0.82-2.17)	1.30 (0.76-2.21)
Urinary tract infections	Women nested	1.68 (1.11-2.54)	1.44 (1.16-1.79)	0.94 (0.72-1.22)	1.47 (1.19-1.81)	1.30 (0.89-1.89)
	Men nested	1.26 (0.63-2.51)	0.99 (0.55-1.76)	2.13 (1.19-3.82)	1.63 (1.00-2.65)	1.04 (0.61-1.79)

CMD: Common mental disorders.