Netherlands Institute of Mental Health and Addiction, P.O. Box 725, Utrecht, The Netherlands.
J Psychosom Res. 2010 Feb;68(2):187-93. doi: 10.1016/j.jpsychores.2009.05.011. Epub 2009 Oct 2.
To disentangle cross-sectionally and longitudinally the relationship between arthritis and psychiatric disorders, and to examine the relationship between age and incidence of (1) any psychiatric disorder among respondents with and without arthritis and (2) arthritis among respondents with and without any psychiatric disorder.
Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a nationally representative household survey with repeated measurements in 1996, 1997 and 1999. Self-report was used to ascertain arthritis. Psychiatric and substance use disorders were diagnosed with the WHO Composite International Diagnostic Interview.
Regarding the cross-sectional results, it was found that the strength of the association of arthritis with mood and anxiety disorders was similar [odds ratio (OR)=1.48, 95% confidence interval (CI)=1.09-1.99 and OR=1.42, 95% CI=1.11-1.81, respectively]. The longitudinal results showed that preexisting arthritis elevated the risk of developing any mood disorder (OR=1.94, 95% CI=1.23-3.07), whereas having any mood or any anxiety disorder did not predict new-onset arthritis. The incidence of any psychiatric disorder was significantly higher among younger persons (<45 years) with arthritis, compared to others in the same age category without arthritis.
Arthritis is associated with psychiatric disorders. The temporal relationship points to one direction: arthritis predicts new onset of psychiatric disorder (mood disorder) instead of the reverse. Especially younger people (<45 years) with arthritis are at risk of developing a psychiatric disorder. Screening and simultaneous treatment of comorbid mood disorder and arthritis are recommended as part of routine in primary care.
为了厘清关节炎与精神障碍之间的横断面和纵向关系，并检验（1）在有关节炎和无关节炎的受访者中任何精神障碍的发生率，以及（2）在有和没有任何精神障碍的受访者中关节炎的发生率与年龄之间的关系。
数据来自荷兰精神健康调查和发病研究（NEMESIS），这是一项全国性的代表性家庭调查，在 1996 年、1997 年和 1999 年进行了重复测量。使用自我报告来确定关节炎。使用世界卫生组织综合国际诊断访谈来诊断精神和物质使用障碍。
关于横断面结果，发现关节炎与情绪和焦虑障碍的关联强度相似[优势比（OR）=1.48，95%置信区间（CI）=1.09-1.99 和 OR=1.42，95% CI=1.11-1.81]。纵向结果表明，先前存在的关节炎会增加患任何情绪障碍的风险（OR=1.94，95% CI=1.23-3.07），而患有任何情绪或任何焦虑障碍并不会预测新发病例的关节炎。与同一年龄段没有关节炎的人相比，有任何精神障碍的关节炎患者中，任何精神障碍的发病率明显更高。
关节炎与精神障碍有关。时间关系指向一个方向：关节炎预示着新的精神障碍（情绪障碍）的发生，而不是相反。特别是年龄较小（<45 岁）的关节炎患者有患精神障碍的风险。建议在初级保健中作为常规筛查和同时治疗合并的情绪障碍和关节炎。
