带状疱疹患者患抑郁症的风险：一项基于全国人群的前瞻性研究。

Risk of depressive disorder among patients with herpes zoster: a nationwide population-based prospective study.

作者信息

Chen Mu-Hong, Wei Han-Ting, Su Tung-Ping, Li Cheng-Ta, Lin Wei-Chen, Chang Wen-Han, Chen Tzeng-Ji, Bai Ya-Mei

机构信息

From the Departments of Psychiatry (M-H.C., H-T.W., T-P.S., C-T.L,W-C.L.,W-H.C.,Y-M.B.), Family Medicine (T-J.C.), and Psychiatry, Yuanshan Branch (H-T.W.), Taipei Veterans General Hospital, Taipei, Taiwan; and Psychiatry, College of Medicine (M-H.C.,H-T.W.,T-P.S.,C-T.L,W-C.L.,Y-M.B.), Institutesof Brain Science (T-P.S.,C-T.L,W-C.L.), and Institutes of Hospital and Health Care Administration (T-J.C.), National Yang-Ming University, Taipei, Taiwan.

出版信息

Psychosom Med. 2014 May;76(4):285-91. doi: 10.1097/PSY.0000000000000051.

DOI:10.1097/PSY.0000000000000051

PMID:24804885

Abstract

OBJECTIVE

Herpes zoster results from reactivation of the endogenous varicella zoster virus infection. Previous studies have shown that herpes zoster and postherpetic neuralgia were associated with anxiety, depression, and insomnia. However, no prospective study has investigated the association between herpes zoster and the development of depressive disorder.

METHODS

Subjects were identified through the Taiwan National Health Insurance Research Database. Patients 18 years or older with a diagnosis of herpes zoster and without a psychiatric history were enrolled in 2000 and compared with age-/sex-matched controls (1:4). These participants were followed up to the end of 2010 for new-onset depressive disorder.

RESULTS

A total of 1888 patients with herpes zoster were identified and compared with 7552 age-/sex-matched controls in 2000. Those with herpes zoster had a higher incidence of developing major depression (2.2% versus 1.4%, p = .018) and any depressive disorder (4.3% versus 3.2%, p = .020) than did the control group. The follow-up showed that herpes zoster was an independent risk factor for major depression (hazard ratio = 1.49, 95% confidence interval = 1.04-2.13) and any depressive disorder (hazard ratio = 1.32, 95% confidence interval = 1.03-1.70), after adjusting demographic data and comorbid medical diseases.

CONCLUSIONS

This is the first study to investigate the temporal association between herpes zoster and depressive disorder. Further studies would be required to clarify the underlying pathophysiology about this association and whether proper treatment of herpes zoster could decrease the long-term risk of depressive disorder.

摘要

目的

带状疱疹由内源性水痘-带状疱疹病毒感染重新激活引起。既往研究表明，带状疱疹及带状疱疹后神经痛与焦虑、抑郁和失眠有关。然而，尚无前瞻性研究调查带状疱疹与抑郁症发生之间的关联。

方法

通过台湾全民健康保险研究数据库识别研究对象。2000年纳入年龄在18岁及以上、诊断为带状疱疹且无精神病史的患者，并与年龄和性别匹配的对照组（1:4）进行比较。对这些参与者随访至2010年底，观察新发抑郁症情况。

结果

2000年共识别出1888例带状疱疹患者，并与7552例年龄和性别匹配的对照组进行比较。带状疱疹患者发生重度抑郁症（2.2% 对1.4%，p = 0.018）和任何抑郁症（4.3% 对3.2%，p = 0.020）的发生率均高于对照组。随访显示，在调整人口统计学数据和合并的内科疾病后，带状疱疹是重度抑郁症（风险比 = 1.49，95% 置信区间 = 1.04 - 2.13）和任何抑郁症（风险比 = 1.32，95% 置信区间 = 1.03 - 1.70）的独立危险因素。