Chuang Yao-Chi, Weng Shih-Feng, Hsu Ya-Wen, Huang Charles Lung-Cheng, Wu Ming-Ping
Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan,
Int Urol Nephrol. 2015 Feb;47(2):275-81. doi: 10.1007/s11255-014-0908-6. Epub 2015 Jan 11.
To explore the association between bladder pain syndrome/interstitial cystitis (BPS/IC) and the risk of subsequent healthcare-seeking behavior for common mental disorders in Taiwan using a population-based administrative database.
Both BPS/IC subjects and their age- and sex-matched non-BPS/IC control subjects who had no previous insomnia and mental diseases, including anxiety, depression, were subsequent serviced for these mental disorders by psychiatrists from the recruited date between 2002 and 2010. The risk of outcomes was assessed with Kaplan-Meier curves; and the impact of BPS/IC was estimated with Poisson regression analysis and Cox proportional hazards models.
We included 16,185 BPS/IC subjects and 32,370 non-BPS/IC subjects, with a mean age of 46 years and 73.5 % of women. Difference of the prevalence of hypertension, diabetes, chronic kidney disease, and hyperlipidemia between groups was not significant difference. Subjects with BPS/IC had a significant higher incidence rate of anxiety, depression, and insomnia than the matched controls (92.9 vs 38.4, 101.0 vs 42.2, 47.5 vs 23.0; per 10,000 person-year). After adjusting for age, sex, and common comorbidities in multivariable analysis, BPS/IC remained a significant predictor with hazard ratio and 95 % confidence incidence, 2.4 (2.2-2.7), 2.4 (2.2-2.6), and 2.1 (1.8-2.4) for anxiety, depression, and insomnia, respectively.
Patients with BPS/IC are at risk of development of anxiety, depression, and insomnia. These findings can help guide urologists, urogynecologists, and psychiatrists toward early identification and treatment of psychological complications that may develop in BPS/IC patients.
利用基于人群的行政数据库,探讨台湾膀胱疼痛综合征/间质性膀胱炎(BPS/IC)与后续常见精神障碍就医行为风险之间的关联。
BPS/IC患者及其年龄和性别匹配的非BPS/IC对照受试者,既往均无失眠及精神疾病,包括焦虑症、抑郁症,自2002年至2010年招募之日起,由精神科医生对这些精神障碍进行后续诊治。采用Kaplan-Meier曲线评估结局风险;采用Poisson回归分析和Cox比例风险模型估计BPS/IC的影响。
我们纳入了16185例BPS/IC患者和32370例非BPS/IC患者,平均年龄46岁,女性占73.5%。两组间高血压、糖尿病、慢性肾脏病和高脂血症的患病率差异无统计学意义。BPS/IC患者焦虑、抑郁和失眠的发病率显著高于匹配的对照组(每10000人年分别为92.9对38.4、101.0对42.2、47.5对23.0)。在多变量分析中调整年龄、性别和常见合并症后,BPS/IC仍然是焦虑、抑郁和失眠的显著预测因素,风险比和95%置信区间分别为2.4(2.2 - 2.7)、2.4(2.2 - 2.6)和2.1(1.8 - 2.4)。
BPS/IC患者有发生焦虑、抑郁和失眠的风险。这些发现有助于指导泌尿外科医生、妇科泌尿医生和精神科医生早期识别和治疗BPS/IC患者可能出现的心理并发症。