Jacob Louis, Spiess Alexandra, Kostev Karel
Faculty of Medicine, University of Paris 5, Paris, France.
IMS Health, Frankfurt, Germany.
Ger Med Sci. 2017 Feb 9;15:Doc04. doi: 10.3205/000245. eCollection 2017.
The purpose of this study was to analyze the prevalence of depression, anxiety, adjustment disorders, and somatoform disorders in patients diagnosed with age-related macular degeneration (AMD) in Germany. This study included 7,580 patients between the ages of 40 and 90 diagnosed with AMD between January 2011 and December 2014 in 1,072 primary care practices (index date). The last follow-up was in July 2016. We also included 7,580 controls without AMD, which were matched (1:1) to the AMD cases by age, sex, type of health insurance (private or statutory), physician, and Charlson comorbidity score as a generic marker of comorbidity. The outcome of the study was the prevalence of depression, anxiety, adjustment disorders, and somatoform disorders recorded in the database between the index date and the end of follow-up. The mean age among subjects was 75.7 years (SD=10.1 years), 34.0% were men, and 7.8% had private health insurance coverage. The Charlson comorbidity index was 2.0 (SD=1.8). Depression was the most frequent disease (33.7% in AMD patients versus 27.3% in controls), followed by somatoform disorders (19.6% and 16.7%), adjustment disorders (14.8% and 10.5%), and anxiety disorders (11.7% and 8.2%). Depression (OR=1.37, 95% CI: 1.27-1.47), anxiety (OR=1.50, 95% CI: 1.35-1.67), adjustment disorders (OR=1.50, 95% CI: 1.36-1.65), and somatoform disorders (OR=1.22, 95% CI: 1.12-1.32) were all positively associated with AMD. Overall, a significant association was found between AMD and depression, anxiety, adjustment disorders, and somatoform disorders.
本研究的目的是分析德国年龄相关性黄斑变性（AMD）患者中抑郁症、焦虑症、适应障碍和躯体形式障碍的患病率。本研究纳入了2011年1月至2014年12月期间在1072家初级保健机构被诊断为AMD的7580名年龄在40至90岁之间的患者（索引日期）。最后一次随访是在2016年7月。我们还纳入了7580名无AMD的对照者，这些对照者按年龄、性别、医疗保险类型（私人或法定）、医生以及作为合并症通用标志物的Charlson合并症评分与AMD病例进行1:1匹配。研究结果是索引日期至随访结束期间数据库中记录的抑郁症、焦虑症、适应障碍和躯体形式障碍的患病率。受试者的平均年龄为75.7岁（标准差=10.1岁），34.0%为男性，7.8%拥有私人医疗保险。Charlson合并症指数为2.0（标准差=1.8）。抑郁症是最常见的疾病（AMD患者中为33.7%，对照者中为27.3%），其次是躯体形式障碍（分别为19.6%和16.7%）、适应障碍（分别为14.8%和10.5%）以及焦虑症（分别为11.7%和8.2%）。抑郁症（比值比=1.37，95%置信区间：1.27 - 1.47）、焦虑症（比值比=1.50，95%置信区间：1.35 - 1.67）、适应障碍（比值比=1.50，95%置信区间：1.36 - 1.65）和躯体形式障碍（比值比=1.22，95%置信区间：1.12 - 1.32）均与AMD呈正相关。总体而言，发现AMD与抑郁症、焦虑症、适应障碍和躯体形式障碍之间存在显著关联。
