Thomsen Anders F, Kessing Lars V
Department of Psychiatry, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
Bipolar Disord. 2005 Aug;7(4):351-7. doi: 10.1111/j.1399-5618.2005.00205.x.
Hyperthyroidism has been associated with affective disorder in many cross-sectional studies, but longitudinal studies in this connection are scarce. We assessed whether hospitalization with depressive disorder or bipolar disorder was a risk factor for development of hyperthyroidism.
We conducted a historical cohort study using the Danish register data. The observational period was 1977--99. Three study cohorts were identified: all patients with a first hospital admission with resulting index discharge diagnoses of depression, bipolar disorder, or osteoarthritis. The risks of subsequently being readmitted with a resulting discharge diagnosis of hyperthyroidism were estimated in survival analyses.
A study sample of 133,570 patients discharged with an index diagnosis was identified. Exactly 610 patients were later readmitted following diagnoses of hyperthyroidism. Patients with depressive disorder did not have an increased risk of hyperthyroidism, whereas patients with bipolar disorder had an increased of risk on the margin of statistical significance, when compared to patients with osteoarthritis. Patients with bipolar disorder had a significantly increased risk of hyperthyroidism when compared to patients with depression.
The results apply only to hospitalized patients. Diagnoses are not validated for research purposes.
Patients hospitalized with bipolar disorder tend to be at greater risk of readmission with hyperthyroidism than suitable control patients.
在许多横断面研究中,甲状腺功能亢进症与情感障碍有关,但这方面的纵向研究很少。我们评估了因抑郁症或双相情感障碍住院是否是甲状腺功能亢进症发生的危险因素。
我们使用丹麦登记数据进行了一项历史性队列研究。观察期为1977年至1999年。确定了三个研究队列:所有首次因抑郁症、双相情感障碍或骨关节炎住院并最终出院诊断为此类疾病的患者。在生存分析中估计了随后因甲状腺功能亢进症出院诊断而再次入院的风险。
确定了一个有133570名患者以指数诊断出院的研究样本。确切地说,有610名患者后来被诊断为甲状腺功能亢进症后再次入院。与骨关节炎患者相比,抑郁症患者患甲状腺功能亢进症的风险没有增加,而双相情感障碍患者患甲状腺功能亢进症的风险在统计学意义边缘有所增加。与抑郁症患者相比,双相情感障碍患者患甲状腺功能亢进症的风险显著增加。
结果仅适用于住院患者。诊断未针对研究目的进行验证。
与合适的对照患者相比,因双相情感障碍住院的患者再次因甲状腺功能亢进症入院的风险往往更高。