Kessing Lars Vedel, Harhoff Mette, Andersen Per Kragh
Department of Psychiatry, Rigshospitalet, Denmark.
Int Clin Psychopharmacol. 2008 Jan;23(1):54-9. doi: 10.1097/YIC.0b013e3282f1c200.
The prevalence of depression and anxiety is increased in patients with multiple sclerosis, but it has not been investigated whether these conditions are treated in clinical practice. The objective of this study was to investigate whether the rate of treatment with antidepressants is increased in patients with multiple sclerosis compared with patients with other chronic illnesses and compared with the general population. By linkage of nationwide case registers, all patients were identified, who had received a main diagnosis of multiple sclerosis or osteoarthritis at first admission or during outpatient contact in the period 1995-2000 in Denmark. Rates of subsequent purchase of antidepressants for these patients were calculated. In total, 417 patients with a main diagnosis of multiple sclerosis and 12 127 patients with a main diagnosis of osteoarthritis, at first discharge from hospital or outpatient contact, were included. Patients with a diagnosis of multiple sclerosis had a 3.21 [95% confidence intervals (CI): 2.56-4.03] times increased rate of subsequently purchasing antidepressants compared with patients with a first diagnosis of osteoarthritis, and a 4.75 times (95% CI: 3.91-5.76) increased rate when compared with the rate among a gender-matched, age-matched, and calendar-matched sample of the general population. The rates were increased in all subgroups of patients regardless of gender, age, socioeconomic group, and time elapsed since diagnosis.
多发性硬化症患者中抑郁症和焦虑症的患病率有所上升，但这些病症在临床实践中是否得到治疗尚未得到研究。本研究的目的是调查与其他慢性病患者以及普通人群相比，多发性硬化症患者使用抗抑郁药治疗的比例是否增加。通过全国病例登记系统的关联，确定了1995年至2000年期间在丹麦首次入院或门诊就诊时被主要诊断为多发性硬化症或骨关节炎的所有患者。计算了这些患者随后购买抗抑郁药的比例。总共纳入了417例主要诊断为多发性硬化症的患者和12127例主要诊断为骨关节炎的患者，这些患者均为首次出院或门诊就诊时的数据。与首次诊断为骨关节炎患者相比，诊断为多发性硬化症的患者随后购买抗抑郁药的比例增加了3.21倍[95%置信区间（CI）：2.56 - 4.03]，与性别匹配、年龄匹配和日历匹配的普通人群样本相比，这一比例增加了4.75倍（95% CI：3.91 - 5.76）。无论性别、年龄、社会经济群体以及诊断后的时间长短，所有患者亚组的比例均有所增加。
