Department of Neurology, General Cathay Hospital, Sijhih Branch, New Taipei City, Taiwan.
School of Health Care Administration, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
Ann Epidemiol. 2014 Mar;24(3):206-13. doi: 10.1016/j.annepidem.2013.12.010. Epub 2014 Jan 1.
The influence of mental illness early in life on the subsequent risk of Parkinson disease (PD) and its clinical picture remain obscure. This study investigated the effects of psychiatric diseases on a subsequent PD diagnosis.
We used the Longitudinal Health Insurance Database 2000 of Taiwan to identify 73,597 patients who visited ambulatory care centers or were hospitalized with a first-time diagnosis of anxiety, affective disorders, or schizophrenia between 2001 and 2003 as the study cohort. We also randomly selected 220,791 enrollees matched with the study cohort for comparison. Each patient was individually tracked for 6 years to identify a subsequent PD diagnosis. Stratified Cox proportional hazard regressions were performed for the analysis.
The incidence rate of PD per 1000 person-years was 4.91 (95% confidence interval [CI], 4.71-5.12) and 1.63 (95% CI, 1.56-1.70) for the psychiatric and comparison groups, respectively. Patients with psychiatric illnesses were more vulnerable to developing PD than nonpsychiatric individuals, exhibiting a 2.38-fold increased risk (95% CI, 2.23-2.53) after other covariates were considered. Furthermore, patients with schizophrenia exhibited the highest risk for developing PD.
We suggest effective monitoring of patients with psychiatric disturbances for potential long-term neurodegenerative diseases.
精神疾病在生命早期对帕金森病（PD）发病风险及其临床表现的影响仍不清楚。本研究旨在探讨精神疾病对 PD 诊断的影响。
我们利用台湾 2000 年长期健康保险数据库，确定了 2001 年至 2003 年间首次被诊断为焦虑症、情感障碍或精神分裂症的 73597 例门诊或住院患者作为研究队列。我们还随机选择了 220791 名与研究队列相匹配的参保人作为对照组。对每位患者进行为期 6 年的个体跟踪随访，以确定其是否患有 PD。采用分层 Cox 比例风险回归分析进行统计分析。
PD 的发病率为每 1000 人年 4.91（95%置信区间[CI]，4.71-5.12）和 1.63（95%CI，1.56-1.70），分别为精神疾病组和对照组。与非精神疾病患者相比，患有精神疾病的患者更易患 PD，在考虑了其他混杂因素后，其发病风险增加了 2.38 倍（95%CI，2.23-2.53）。此外，精神分裂症患者发生 PD 的风险最高。
我们建议对有精神障碍的患者进行有效的监测，以预防潜在的长期神经退行性疾病。
