Meier Sandra M, Petersen Liselotte, Mattheisen Manuel, Mors Ole, Mortensen Preben B, Laursen Thomas M
National Centre for Register-Based Research, Aarhus University, Aarhus V, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus C, Denmark.
National Centre for Register-Based Research, Aarhus University, Aarhus V, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus C, Denmark.
Lancet Psychiatry. 2015 Jun;2(6):515-23. doi: 10.1016/S2215-0366(15)00092-9. Epub 2015 May 14.
Depression and anxiety disorders are highly comorbid conditions and a worldwide disease burden; however, large-scale studies delineating their association are scarce. In this retrospective study, we aimed to assess the effect of severe anxiety disorders on the risk and course of depression.
We did a population-based cohort study with prospectively gathered data in Denmark using data from three Danish population registers: The Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Registry. We selected the cohort from people born in Denmark between Jan 1, 1955, and Dec 31, 2002, who we followed up from Jan 1, 1994, to Dec 31, 2012. The cohort was restricted to individuals with known parents. First, we investigated the effect of specific anxiety diagnoses on risk of single depressive episodes and recurrent depressive disorder. Second, we investigated the effect of comorbid anxiety on risk of readmission for depression, adjusting for sex, age, calendar year, parental age, place at residence at time of birth, and the interaction of age with sex.
We included 3,380,059 individuals in our study cohort. The adjusted incidence rate ratio (IRR) for single depressive episodes was 3·0 (95% CI 2·8-3·1, p<0·0001) and for recurrent depressive disorder was 5·0 (4·8-5·2) in patients with severe anxiety disorders compared with the general population. Compared with control individuals, the offspring of parents with anxiety disorders were more likely to be diagnosed with single depressive episodes (1·9, 1·8-2·0) or recurrent depressive disorder (2·1, 1·9-2·2). Comorbid anxiety increased the readmission rates in both patients with single depressive episodes and patients with recurrent depressive disorder.
Severe anxiety constitutes a significant risk factor for depression. Focusing on specific anxiety disorders might help to identify individuals at risk of depression, thereby providing new insights for prevention and treatment.
The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH).
抑郁症和焦虑症是高度共病的情况，也是一种全球疾病负担；然而，描述它们之间关联的大规模研究很少。在这项回顾性研究中，我们旨在评估严重焦虑症对抑郁症风险和病程的影响。
我们在丹麦进行了一项基于人群的队列研究，前瞻性地收集了来自丹麦三个人口登记处的数据：丹麦民事登记系统、丹麦精神病学中央登记处和丹麦国家医院登记处。我们从1955年1月1日至2002年12月31日在丹麦出生的人群中选取队列，并于1994年1月1日至2012年12月31日对其进行随访。该队列仅限于父母信息已知的个体。首先，我们研究了特定焦虑症诊断对单次抑郁发作和复发性抑郁症风险的影响。其次，我们研究了共病焦虑对抑郁症再入院风险的影响，并对性别、年龄、日历年份、父母年龄、出生时的居住地点以及年龄与性别的相互作用进行了调整。
我们的研究队列包括3380059名个体。与普通人群相比，患有严重焦虑症的患者单次抑郁发作的调整发病率比值（IRR）为3.0（95%CI 2.8 - 3.1，p<0.0001），复发性抑郁症的调整发病率比值为5.0（4.8 - 5.2）。与对照个体相比，患有焦虑症父母的后代更有可能被诊断为单次抑郁发作（1.9，1.8 - 2.0）或复发性抑郁症（2.1，1.9 - 2.2）。共病焦虑增加了单次抑郁发作患者和复发性抑郁症患者的再入院率。
严重焦虑是抑郁症的一个重要风险因素。关注特定的焦虑症可能有助于识别有抑郁症风险的个体，从而为预防和治疗提供新的见解。
伦贝克综合精神病学研究基金会倡议（iPSYCH）。
