重度单相抑郁症患者的死亡率和预期寿命

Mortality and life expectancy in persons with severe unipolar depression.

作者信息

Laursen Thomas Munk, Musliner Katherine L, Benros Michael E, Vestergaard Mogens, Munk-Olsen Trine

机构信息

National Centre for Register-based Research, Department of Economics and Business, Aarhus University, Denmark.

National Centre for Register-based Research, Department of Economics and Business, Aarhus University, Denmark; Department of Mental Health, Bloomberg school of Public Health, Johns Hopkins University, Baltimore, USA.

出版信息

J Affect Disord. 2016 Mar 15;193:203-7. doi: 10.1016/j.jad.2015.12.067. Epub 2016 Jan 6.

DOI:10.1016/j.jad.2015.12.067

PMID:26773921

Abstract

BACKGROUND

Depression is a common psychiatric disorder, with a lifetime prevalence of 10-15% in the Danish population. Although depression is associated with excess mortality, it is not yet understood how this affects life expectancy. Our aim was to examine mortality rates and life expectancy in patients with unipolar depression compared to the general population, and to assess the impact of comorbid somatic illness and substance abuse.

METHODS

We followed a Danish population-based cohort from 1995-2013 (N=5,103,699). The cohort included all residents in Denmark during the study period. Mortality rate ratios (MRRs) and life expectancy in persons with unipolar depression were calculated using survival analysis techniques.

RESULTS

The overall MRR was 2.07 (95% Confidence Interval (CI): 2.05-2.09) in people with a previous unipolar depression diagnosis compared to the general Danish population. This excess mortality translated into a reduced life expectancy of 14.0 years in men and 10.1 years in women (assuming onset at age 15). The MRR was highest for death due to suicide and accidents (MRR: 4.66; 95% CI: 4.53-4.79), but the absolute number of deaths was highest for natural causes.

CONCLUSION

People with unipolar depression have a significant shorter life expectancy, especially men.

摘要

背景

抑郁症是一种常见的精神障碍，在丹麦人群中的终生患病率为10%-15%。尽管抑郁症与过高的死亡率相关，但目前尚不清楚这如何影响预期寿命。我们的目的是研究单相抑郁症患者与普通人群相比的死亡率和预期寿命，并评估合并躯体疾病和药物滥用的影响。

方法

我们对1995年至2013年丹麦基于人群的队列进行了随访（N=5,103,699）。该队列包括研究期间丹麦的所有居民。使用生存分析技术计算单相抑郁症患者的死亡率比（MRR）和预期寿命。

结果

与丹麦普通人群相比，既往有单相抑郁症诊断的人群总体MRR为2.07（95%置信区间（CI）：2.05-2.09）。这种过高的死亡率导致男性预期寿命缩短14.0岁，女性缩短10.1岁（假设发病年龄为15岁）。自杀和事故导致的死亡MRR最高（MRR：4.66；95%CI：4.53-4.79），但自然原因导致的死亡绝对数量最高。