Linking Kawasaki Disease to Mental Health: A Nationwide Study on Long-Term Neurological Risks
Abstract
1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Study Design and Population
2.3. Study Outcomes
2.4. Ethics
2.5. Statistical Analysis
3. Results
3.1. Demographics of Study Participants
3.2. Risk of Neuropsychiatric Disorders
3.3. Risk of Neurodevelopmental Disorders
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
KD | Kawasaki Disease |
ADHD | Attention Deficit Hyperactivity Disorder |
HR | Hazard Ratio |
OR | Odds Ratio |
SPECT | Single-Photon Emission Computed Tomography |
NHIS | National Health Insurance Service |
References
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Variables | KD Cases (n = 41,806) | Controls (n = 163,829) | p-Value |
---|---|---|---|
Age | |||
Mean (years) | 2.63 ± 1.84 | 2.64 ± 1.85 | 0.119 |
≤2 years | 22,038 (52.71) | 85,992 (52.49) | 0.225 |
3–4 years | 13,376 (32.00) | 52,226 (31.88) | |
≥5 years | 6392 (15.29) | 25,611 (15.63) | |
Sex (female) | 17,643 (42.20) | 69,709 (42.55) | 0.199 |
Urbanicity | 0.025 | ||
Urban | 28,054 (67.11) | 108,991 (66.53) | |
Non-urban | 13,752 (32.89) | 54,838 (33.47) |
Kawasaki Disease | Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|---|
Case (n, %) | No | Yes | HR (95% CI) | p-Value | HR (95% CI) | p-Value |
Psychotic disorder (−) | 163,536 (95.82) | 41,722 (99.80) | 1.000 | 1.000 | ||
Psychotic disorder (+) | 293 (0.18) | 84 (0.20) | 1.096 (0.859–1.400) | 0.459 | 1.097 (0.859–1.400) | 0.459 |
Mood disorder (−) | 161,639 (98.66) | 41,218 (98.59) | 1.000 | 1.000 | ||
Mood disorder (+) | 2190 (1.34) | 588 (1.41) | 1.068 (0.975–1.170) | 0.156 | 1.074 (0.980–1.176) | 0.126 |
Anxiety disorder (−) | 160,403 (97.91) | 40,835 (97.68) | 1.000 | 1.000 | ||
Anxiety disorder (+) | 3426 (2.09) | 971 (2.32) | 1.124 (1.046–1.207) | 0.001 | 1.124 (1.047–1.207) | 0.001 |
Sleep-related disorder (−) | 163,027 (99.51) | 41,539 (99.36) | 1.000 | 1.000 | ||
Sleep-related disorder (+) | 802 (0.49) | 267 (0.64) | 1.254 (1.091–1.441) | 0.001 | 1.257 (1.094–1.444) | 0.001 |
Cognitive disorder (−) | 158,718 (96.88) | 40,446 (96.75) | 1.000 | 1.000 | ||
Cognitive disorder (+) | 5111 (3.12) | 1360 (3.25) | 1.046 (0.985–1.111) | 0.140 | 1.049 (0.988–1.114) | 0.118 |
Movement disorder (−) | 163,309 (99.68) | 41,636 (99.59) | 1.000 | 1.000 | ||
Movement disorder (+) | 520 (0.32) | 170 (0.41) | 1.222 (1.026–1.454) | 0.025 | 1.227 (1.030–1.461) | 0.022 |
Personality disorder (−) | 163,439 (96.76) | 41,686 (99.71) | 1.000 | 1.000 | ||
Personality disorder (+) | 390 (0.24) | 120 (0.29) | 1.219 (0.993–1.496) | 0.058 | 1.215 (0.990–1.492) | 0.063 |
Any disorder (−) | 155,234 (94.75) | 39,400 (94.24) | 1.000 | 1.000 | ||
Any disorder (+) | 8595 (5.25) | 2406 (5.76) | 1.101 (1.053–1.152) | <0.001 | 1.102 (1.053–1.153) | <0.001 |
Kawasaki Disease | Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|---|
Case (n, %) | No | Yes | HR (95% CI) | p-Value | HR (95% CI) | p-Value |
Intellectual disorder (−) | 162,817 (99.38) | 41,612 (99.54) | 1.000 | 1.000 | ||
Intellectual disorder (+) | 1012 (0.62) | 194 (0.46) | 0.747 (0.640–0.871) | <0.001 | 0.747 (0.641–0.871) | <0.001 |
Communication disorder (−) | 163,051 (99.53) | 41,628 (99.57) | 1.000 | 1.000 | ||
Communication disorder (+) | 778 (0.47) | 178 (0.43) | 0.897 (0.762–1.056) | 0.192 | 0.894 (0.760–1.052) | 0.179 |
Specific learning disorder (−) | 163,708 (99.93) | 41,785 (99.95) | 1.000 | 1.000 | ||
Specific learning disorder (+) | 121 (0.07) | 21 (0.05) | 0.643 (0.400–1.033) | 0.068 | 0.641 (0.399–1.030) | 0.066 |
Autism spectrum disorder (−) | 163,226 (99.63) | 41,670 (99.67) | 1.000 | 1.000 | ||
Autism spectrum disorder (+) | 603 (0.37) | 136 (0.33) | 0.876 (0.727–1.056) | 0.165 | 0.872 (0.724–1.051) | 0.150 |
ADHD (−) | 160,512 (97.98) | 40,951 (97.95) | 1.000 | 1.000 | ||
ADHD (+) | 3317 (2.02) | 855 (2.05) | 1.021 (0.947–1.101) | 0.580 | 1.017 (0.943–1.096) | 0.663 |
Tic disorder (−) | 162,608 (99.25) | 41,451 (99.15) | 1.000 | 1.000 | ||
Tic disorder (+) | 1221 (0.75) | 355 (0.85) | 1.154 (1.025–1.298) | 0.018 | 1.148 (1.020–1.292) | 0.022 |
Any disorder (−) | 157,926 (96.40) | 40,262 (96.31) | 1.000 | 1.000 | ||
Any disorder (+) | 5903 (3.60) | 1544 (3.69) | 1.029 (0.973–1.088) | 0.322 | 1.027 (0.971–1.086) | 0.361 |
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Lee, J.-H.; Shin, T.; Park, J.-M.; Seol, J.-H. Linking Kawasaki Disease to Mental Health: A Nationwide Study on Long-Term Neurological Risks. Medicina 2025, 61, 604. https://doi.org/10.3390/medicina61040604
Lee J-H, Shin T, Park J-M, Seol J-H. Linking Kawasaki Disease to Mental Health: A Nationwide Study on Long-Term Neurological Risks. Medicina. 2025; 61(4):604. https://doi.org/10.3390/medicina61040604
Chicago/Turabian StyleLee, Ji-Ho, Taewoo Shin, Jung-Min Park, and Jae-Hee Seol. 2025. "Linking Kawasaki Disease to Mental Health: A Nationwide Study on Long-Term Neurological Risks" Medicina 61, no. 4: 604. https://doi.org/10.3390/medicina61040604
APA StyleLee, J.-H., Shin, T., Park, J.-M., & Seol, J.-H. (2025). Linking Kawasaki Disease to Mental Health: A Nationwide Study on Long-Term Neurological Risks. Medicina, 61(4), 604. https://doi.org/10.3390/medicina61040604