钩端螺旋体病与抑郁症：一项全国性队列分析。

Leptospirosis and Depression: A Nationwide Cohort Analysis.

作者信息

Chiu Chun-Hsiang, Wang Ying-Chuan, Lin Cheng-Li, Lee Feng-You, Kao Chia-Hung

机构信息

Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.

Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei City, Taiwan.

出版信息

J Clin Psychiatry. 2017 Apr;78(4):e398-e403. doi: 10.4088/JCP.16m10773.

DOI:10.4088/JCP.16m10773

PMID:28297597

Abstract

OBJECTIVE

We conducted a retrospective cohort study to investigate whether leptospirosis is a risk factor for depression.

METHOD

From the Taiwan National Health Insurance Research Database between 2000 and 2010, patients with leptospirosis (ICD-9 code 100) who did not have a history of depression (ICD-9-CM codes 296.2, 296.3, 300.4, and 311) before the index date were enrolled (leptospirosis cohort). For each patient with leptospirosis, 1 control without a history of leptospirosis and depression was randomly selected (nonleptospirosis cohort). Cox proportional hazards regression models were used to analyze the risk of depression according to sex, age, and comorbidities.

RESULTS

In the leptospirosis and nonleptospirosis cohorts, we observed 34 patients with depression, with the incidence rate of 2.87 per 1,000 person-years, and 25 patients with depression, with the incidence rate of 1.93 per 1,000 person-years, respectively, yielding a crude hazard ratio (HR) of 1.49 (95% confidence interval [CI], 1.25-1.77) and an adjusted HR (aHR) of 1.58 (95% CI, 1.34-1.88). Compared with the nonleptospirosis cohort, the leptospirosis cohort had a risk of depression stratified by sex, age, and comorbidity that was higher in female patients (aHR = 2.08; 95% CI, 1.54-2.80), patients younger than 49 years old (aHR = 3.19; 95% CI, 2.39-4.27), and patients without comorbidity (aHR = 2.14; 95% CI, 1.68-2.71). The risk of depression was higher in women than in men (aHR = 1.90; 95% CI, 1.61-2.25) and in patients with comorbidities, namely hyperlipidemia (aHR = 1.80; 95% CI, 1.40-2.31), coronary artery disease (aHR = 2.47; 95% CI, 1.96-3.12), stroke (aHR = 1.77; 95% CI, 1.39-2.24), and septicemia (aHR = 2.06; 95% CI, 1.64-2.58).

CONCLUSIONS

Patients with leptospirosis have a 1.58-fold higher risk of depression than that in the general population. Physicians should be alert to the emotional condition and depression symptoms of people who had been suffering from leptospirosis.

摘要

目的

我们开展了一项回顾性队列研究，以调查钩端螺旋体病是否为抑郁症的一个风险因素。

方法

从2000年至2010年的台湾全民健康保险研究数据库中，纳入索引日期前无抑郁症病史（国际疾病分类第九版临床修正版编码296.2、296.3、300.4和311）的钩端螺旋体病患者（国际疾病分类第九版编码100）（钩端螺旋体病队列）。对于每例钩端螺旋体病患者，随机选取1名无钩端螺旋体病和抑郁症病史的对照者（非钩端螺旋体病队列）。采用Cox比例风险回归模型，根据性别、年龄和合并症分析抑郁症风险。