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ObjectiveTo assess whether bed bug infestation was linked to sleep disturbances and symptoms of anxiety and depression.DesignExploratory cross-sectional study.SettingConvenience sample of tenants recruited in apartment complexes from Montreal, Canada.Participants39 bed bug-exposed tenants were compared with 52 unexposed tenants.Main outcome measuresThe effect of bed bug-exposed tenants on sleep disturbances, anxiety and depression symptoms measured using the Pittsburgh Sleep Quality Index, 5th subscale, Generalised Anxiety Disorder 7-item scale and Patient Health Questionnaire, 9-item, respectively.ResultsIn adjusted models, bed bug infestation was strongly associated with measured anxiety symptoms (OR (95% CI)=4.8 (1.5 to 14.7)) and sleep disturbance (OR (95% CI)=5.0 (1.3–18.8)). There was a trend to report more symptoms of depression in the bed bug-infested group, although this finding was not statistically significant ((OR (95% CI)=2.5(0.8 to 7.3)).ConclusionsThese results suggest that individuals exposed to bed bug infestations are at risk of experiencing sleep disturbance and of developing symptoms of anxiety and possibly depression. Greater clinical awareness of this problem is needed in order for patients to receive appropriate mental healthcare. These findings highlight the need for undertaking of deeper inquiry, as well as greater collaboration between medical professionals, public health and community stakeholders.

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Patient:Male, 62Final Diagnosis:Bipolar disorderSymptoms:Bordeline personality disorderMedication:—Clinical Procedure:Bed bug infestationSpecialty:PsychiatryObjective:Unusual clinical courseBackground:In the past decade, bed bug infestations have been increasingly common in high income countries. Psychological consequences of these infestations are rarely examined in the scientific literature.Case Report:We present a case, based on a coroner’s investigation report, of a woman with previous psychiatric morbidity who jumped to her death following repeated bed bug infestations in her apartment. Our case report shows that the bed bug infestations were the likely trigger for the onset a negative psychological state that ultimately led to suicide.Conclusions:Given the recent surge in infestations, rapid action needs to be taken not only in an attempt to control and eradicate the bed bugs but also to adequately care for those infested by bed bugs.

The association between environmental exposures and Parkinson's disease continues to garner interest. In the late 1980s, Barbeau et al. reported in the Canadian Journal of Neurological Sciences a heterogeneous distribution of Parkinson's disease cases across the province of Québec by hydrographic region. Here we report the findings of a validation study based on data obtained from the Québec medication insurance program-information which was unavailable to the previous group. Similar to Barbeau et al., our analysis showed a heterogeneous distribution of cases across the province with higher prevalence in the same region of interest, in addition to other areas.