Jacob Louis, Rockel Timo, Kostev Karel
Faculty of Medicine, University of Paris 5, Paris, France.
Epidemiology, QuintilesIMS, Frankfurt, Germany.
Rheumatol Ther. 2017 Jun;4(1):195-200. doi: 10.1007/s40744-017-0058-2. Epub 2017 Mar 20.
Rheumatoid arthritis (RA) is one of the most common chronic inflammatory diseases. The goal of this study was to analyze the risk of depression in patients diagnosed with RA and treated by general practitioners in the UK.
The present study included patients first diagnosed with RA between 2000 and 2014 (index date). Individuals were excluded if they had also been diagnosed with depression or if they had received therapy for depression at or prior to the index date. The primary outcome measure was the rate of patients with depression (ICD 10: F32, 33) within 5 years of the RA diagnosis. Demographic data included gender and age. Furthermore, a revised version of the Charlson comorbidity index was used as a generic marker of comorbidity.
A total of 4187 patients were included in the study. After 5 years of follow-up, 23.7% of men and 36.5% of women had developed depression (log rank p value <0.001). Women were more likely to develop depression than men (HR 1.61, 95% CI 1.42-1.84). Age and Charlson comorbidity score had no significant impact on the risk of being diagnosed with this psychiatric disorder.
Around 30% of RA patients developed depression within 5 years of the RA diagnosis. The depression risk was higher in women than in men. The current findings also indicate that improved detection and treatment of patients with both RA and depression are important.
类风湿性关节炎(RA)是最常见的慢性炎症性疾病之一。本研究的目的是分析在英国被全科医生诊断为RA并接受治疗的患者中患抑郁症的风险。
本研究纳入了2000年至2014年首次被诊断为RA的患者(索引日期)。如果个体同时被诊断患有抑郁症或在索引日期或之前接受过抑郁症治疗,则将其排除。主要结局指标是RA诊断后5年内抑郁症患者(国际疾病分类第10版:F32、33)的发生率。人口统计学数据包括性别和年龄。此外,修订版的查尔森合并症指数被用作合并症的通用指标。
共有4187名患者纳入研究。经过5年的随访,23.7%的男性和36.5%的女性出现了抑郁症(对数秩检验p值<0.001)。女性比男性更易患抑郁症(风险比1.61,95%置信区间1.42 - 1.84)。年龄和查尔森合并症评分对被诊断患有这种精神疾病的风险没有显著影响。
约30%的RA患者在RA诊断后5年内出现抑郁症。女性的抑郁症风险高于男性。目前的研究结果还表明,改善对RA和抑郁症患者的检测和治疗很重要。