Shiba M, Bower J H, Maraganore D M, McDonnell S K, Peterson B J, Ahlskog J E, Schaid D J, Rocca W A
Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Mov Disord. 2000 Jul;15(4):669-77. doi: 10.1002/1531-8257(200007)15:4<669::aid-mds1011>3.0.co;2-5.
We studied the association between preceding psychiatric disorders and Parkinson's disease (PD) using a case-control design. We used the medical records-linkage system of the Rochester Epidemiology Project to identify 196 subjects who developed PD in Olmsted County, Minnesota, during the years 1976-1995. Each case was matched by age (+/-1 yr) and sex to a general population control. We reviewed the complete medical records of cases and control subjects to detect preceding psychiatric disorders. The frequency of psychiatric disorders was higher in cases than in control subjects; the odds ratio was 2.2 for anxiety disorders (95% confidence interval [95% CI] = 1.4-3.4; p = 0.0003), 1.9 for depressive disorders (95% CI = 1.1-3.2; p = 0.02), and 2.4 for both anxiety disorders and depressive disorders occurring in the same individual (95% CI = 1.2-4.8; p = 0.02). When we restricted analyses to disorders present 5 years or more before the onset of motor symptoms of PD, the association with depressive disorders lost statistical significance. However, the association with anxiety disorders remained significant for disorders present 5, 10, or 20 years before onset of motor symptoms. Our results suggest that anxiety disorders and depressive disorders are associated with PD and that the causative process or the risk factors underlying PD are present many years before the appearance of motor symptoms.
我们采用病例对照设计研究了既往精神障碍与帕金森病（PD）之间的关联。我们利用罗切斯特流行病学项目的医疗记录链接系统，确定了1976年至1995年间在明尼苏达州奥尔姆斯特德县患帕金森病的196名受试者。每个病例按照年龄（±1岁）和性别与一名普通人群对照进行匹配。我们查阅了病例和对照受试者的完整医疗记录，以检测既往精神障碍。病例组中精神障碍的发生率高于对照组；焦虑症的优势比为2.2（95%置信区间[95%CI]=1.4 - 3.4；p = 0.0003），抑郁症为1.9（95%CI = 1.十一3.2；p = 0.02），同一人同时患焦虑症和抑郁症为2.4（95%CI = 1.2 - 4.8；p = 0.02）。当我们将分析限制在帕金森病运动症状出现前5年或更长时间存在得障碍时，与抑郁症的关联失去统计学意义。然而，对于运动症状出现前5年、10年或20年存在的障碍，与焦虑症的关联仍然显著。我们的结果表明，焦虑症和抑郁症与帕金森病有关，并且帕金森病的致病过程或潜在风险因素在运动症状出现前许多年就已存在。
