Lin Tzu-Chin, Lee Charles Tzu-Chi, Lai Te-Jen, Lee Chun-Te, Lee Kang-Yun, Chen Vincent Chin-Hung, Stewart Robert
Department of Psychiatry, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., Taichung 40201, Taiwan; Department of Psychiatry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Affect Disord. 2014 Oct;168:30-6. doi: 10.1016/j.jad.2014.06.033. Epub 2014 Jul 2.
The relationship between asthma and bipolar disorder has received little research. We sought to investigate this in a large national sample. Previous studies have found mood changes after prednisone use in asthma patients, and we therefore also investigated this exposure in relation to bipolar disorder.
Cases were identified from Taiwan׳s National Health Insurance Research Database with a new primary diagnosis of asthma (ICD-9:493) between 2000 and 2007. Case status required the presence of any inpatient diagnosis of asthma and/or at least one year diagnosis of asthma in outpatient service. These 46,558 cases were compared to 46,558 sex-, age-, residence- and insurance premium-matched controls and both groups were followed until the end of 2008 for first diagnosis of bipolar disorder (ICD-9 codes 296.0 to 296.16, 296.4 to 296.81 and 296.89). Competing risk adjusted Cox regression analyses were applied, adjusting for sex, age, residence, insurance premium, prednisone, hyperthyroidism, COPD (chronic obstructive pulmonary disease), Charlson comorbidity index, and hospital admission days for any disorder.
Of the 93,116 subjects, 161 were ascertained as having bipolar disorder during a mean (SD) follow-up period of 5.7 (2.2) years. Asthma was an independent risk for bipolar disorder in the fully adjusted model. Higher daily dose of prednisone was a risk factor in asthma cases.
The severity of asthma and bipolar disorder, and the route/duration of prednisone treatment were not evaluated.
Asthma was associated with increased risk of bipolar disorder. Higher daily dose of prednisone was associated with a further increased risk.
哮喘与双相情感障碍之间的关系鲜有研究。我们试图在一个大型全国性样本中对此进行调查。既往研究发现哮喘患者使用泼尼松后会出现情绪变化，因此我们还研究了这种暴露与双相情感障碍的关系。
从台湾国民健康保险研究数据库中识别出2000年至2007年间首次诊断为哮喘（国际疾病分类第九版：493）的病例。病例状态要求存在任何哮喘住院诊断和/或门诊至少一年的哮喘诊断。将这46558例病例与46558例性别、年龄、居住地和保险费匹配的对照进行比较，两组均随访至2008年底，以观察双相情感障碍的首次诊断（国际疾病分类第九版编码296.0至296.16、296.4至296.81和296.89）。应用竞争风险调整后的Cox回归分析，对性别、年龄、居住地、保险费、泼尼松、甲状腺功能亢进、慢性阻塞性肺疾病（COPD）、Charlson合并症指数以及任何疾病的住院天数进行调整。
在93116名受试者中，在平均（标准差）5.7（2.2）年的随访期内，有161人被确定患有双相情感障碍。在完全调整模型中，哮喘是双相情感障碍的独立危险因素。哮喘病例中，较高的泼尼松日剂量是一个危险因素。
未评估哮喘和双相情感障碍的严重程度以及泼尼松治疗的途径/持续时间。
哮喘与双相情感障碍风险增加有关。较高的泼尼松日剂量与进一步增加的风险有关。
