Chan Yee-Lam E, Bai Ya-Mei, Hsu Ju-Wei, Huang Kai-Lin, Su Tung-Ping, Li Cheng-Ta, Lin Wei-Chen, Pan Tai-Long, Chen Tzeng-Ji, Tsai Shih-Jen, Chen Mu-Hong
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Am J Geriatr Psychiatry. 2017 Aug;25(8):917-923. doi: 10.1016/j.jagp.2017.03.012. Epub 2017 Mar 23.
Increasing evidence has suggested a relationship between post-traumatic stress disorder (PTSD) and neurodegenerative disorder, such as Alzheimer disease. The association between PTSD and Parkinson disease (PD), however, remains unclear.
Using the Taiwan National Health Insurance Research Database, 7,280 subjects (1,456 patients aged ≥45 years with PTSD and 5,824 age-/sex-matched individuals without PTSD) were enrolled between 2002 and 2009 and followed to the end of 2011. Subjects who developed PD during the follow-up period were identified.
An increased risk of developing PD was found in patients with PTSD (Wald χ = 12.061, hazard ratio [HR]: 3.46, 95% confidence interval [CI]: 1.72-6.96) compared with individuals without PTSD, after adjusting for demographic data and medical and psychiatric comorbidities. The sensitivity tests after excluding the first year observation (Wald χ = 7.948, HR: 3.01, 95% CI: 1.40-6.46) and the first 3-year observation (Wald χ = 5.099, HR: 3.07, 95% CI: 1.16-8.15) were consistent.
Patients with PTSD had an elevated risk of developing PD in later life. Further studies would be required to clarify the exact pathophysiology between PTSD and PD and to investigate whether the prompt intervention for PTSD may reduce this risk.
越来越多的证据表明创伤后应激障碍(PTSD)与神经退行性疾病(如阿尔茨海默病)之间存在关联。然而,PTSD与帕金森病(PD)之间的关联仍不明确。
利用台湾国民健康保险研究数据库,在2002年至2009年期间纳入了7280名受试者(1456名年龄≥45岁的PTSD患者和5824名年龄及性别匹配的无PTSD个体),并随访至2011年底。确定在随访期间发生PD的受试者。
在调整人口统计学数据以及医学和精神共病因素后,发现PTSD患者发生PD的风险增加(Waldχ=12.061,风险比[HR]:3.46,95%置信区间[CI]:1.72 - 6.96),与无PTSD的个体相比。排除第一年观察期后的敏感性测试(Waldχ=7.948,HR:3.01,95%CI:1.40 - 6.46)和前3年观察期后的敏感性测试(Waldχ=5.099,HR:3.07,95%CI:1.16 - 8.15)结果一致。
PTSD患者在晚年发生PD的风险升高。需要进一步研究以阐明PTSD与PD之间的确切病理生理学,并调查对PTSD的及时干预是否可以降低这种风险。