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Depression and use of antidepressants is associated with increased risk of Clostridium difficile infection

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Question: Is depression, or the use of antidepressants, associated with increased risk of Clostridium difficile infection (CDI)?

People: Study 1: 16 781 adults (mean age 67.9 years±10.6 years, 56.2% female) have participated in the Health and Retirement Study (HRS). The HRS interviews older adults every 2 years. Data from the interviews were linked to relevant Centers for Medicare and Medicaid Services files (CMS) which record inpatient, outpatient, skilled nursing facility, carrier (part B) and Home Health Agency data. Study 2: A total of 4047 adult inpatients at the University of Michigan Health System (UMHS) whose stools were tested for C difficile. Adults hospitalised for C difficile were excluded as only hospital-acquired infections were of interest. Cases were adults testing positive for C difficile 48 h or longer after admission; controls were adults testing negative for C difficile 48 h or longer after admission.

Setting: Study 1: HRS Study, USA; interview data from 1992 to 2006. Study 2: UMHS, August 2010 to February 2012.

Risk factors: Study 1: Diagnoses of depression, depressive disorders and major depression (International Classification of Diseases, ninth …

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