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European Journal of Psychiatry

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European Journal of Psychiatry Risk of severe bacterial infection among offspring of patients with bipolar diso...
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Vol. 40. Issue 1.
(January - March 2026)
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Vol. 40. Issue 1.
(January - March 2026)

Risk of severe bacterial infection among offspring of patients with bipolar disorder: A family-linkage study

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Dian-Jeng Lia,b, Shih-Jen Tsaic,d, Ya-Mei Baic,d, Tung-Ping Suc,d,e, Tzeng-Ji Chenf,g,h, Mu-Hong Chenc,d,,
Corresponding author
kremer7119@gmail.com

Corresponding author at: Department of Psychiatry, No. 201, Sec. 2, Shihpai Road, Beitou District, Taipei 11217, Taiwan.
, Chih-Sung Liangi,j,,**
Corresponding author
lcsyfw@gmail.com

Corresponding author at: Department of Psychiatry, No. 60, Xinmin Road, Beitou District, Taipei 11243, Taiwan.
a Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
b Department of Nursing, Meiho University, Pingtung 91200, Taiwan
c Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
d Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
e Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
f Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
g Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
h Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan
i Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical School, Taipei, Taiwan
j Department of Psychiatry, National Defense Medical School, Taipei, Taiwan
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Abstract
Background and objectives

The medical comorbidities associated with bipolar disorder (BD) impose a heavy burden on society. We aimed to investigate the association between parental BD and severe bacterial infection among their offspring.

Methods

We used data from the Taiwan National Health Insurance Research Database. Individuals whose parents were diagnosed with BD were identified as the index group, and a demographically matched control group was also selected. The primary outcome was hospitalization due to bacterial infection, and the bacterial pathogens were recorded. Cox regression models with multiple adjustments were used to estimate the hazard ratios (HRs) with 95 % confidence intervals (CIs).

Results

The study included 8707 offspring of parents with BD and 87,070 offspring of parents without severe mental disorders. After adjustments, the offspring of parents with BD had higher risks of severe bacterial infection (HR: 1.2, 95 % CI: 1.03–1.39), meningitis (HR: 1.45, 95 % CI: 1.02–2.06), and Klebsiella infection (HR: 3.76, 95 % CI: 1.58–8.94) than the controls. In addition, the offspring of fathers with BD had higher risks of severe bacterial infection, repeated severe bacterial infection, and septicemia than the offspring of fathers without a severe mental disorder.

Conclusions

We identified an association between parental BD and an increased risk of bacterial infection in their offspring. Further research is warranted to better clarify the detailed mechanisms behind it.

Keywords:
Severe bacterial infection
Bipolar disorder
Parent
Offspring
Klebsiella

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