Chen I-Chun, Lee MingHuei, Wu Shang-Liang, Lin Hsuan-Hung, Chang Kun-Min, Lin HsiuYing
1 Department of Psychiatry, Taichung Veterans General Hospital, Taiwan.
2 Department of Urology, Feng-Yuan Hospital, Ministry of Health and Welfare, Taiwan.
Int J Psychiatry Med. 2017 Jan;52(1):48-61. doi: 10.1177/0091217417703286. Epub 2017 Apr 11.
Objectives Somatic symptoms are somatic complaints accompanied by disproportionate thoughts, feelings, and behaviors related to such symptoms. The study investigated five International Classification of Diseases, Ninth Revision, Clinical Modification diagnoses hallmarked by somatic symptoms. The study hypothesized an increased risk of interstitial cystitis/bladder pain syndrome in patients with somatic symptoms. Methods The raw data were obtained from a nationwide health insurance reimbursement database over a 12-year period from 2002 to 2013. The study followed a somatic symptoms cohort ( n = 34,393) and non-somatic symptoms cohort ( n = 637,999) for interstitial cystitis/bladder pain syndrome. Both cohorts were stratified into three subgroups based on propensity scores calculated by sex, age, and 17 comorbidities of interstitial cystitis/bladder pain syndrome. Results The incidence density of interstitial cystitis/bladder pain syndrome between the somatic symptoms cohort and non-somatic symptoms cohort was significantly different in the three subgroups (relative ratio [95% confidence interval], 2.14 [1.01, 4.53], 1.52 [1.47, 1.57], and 1.59 [1.28, 1.98], respectively). The adjusted hazard ratio for interstitial cystitis/bladder pain syndrome was significantly greater in the female-dominant and older age subgroups-subgroup 2 and subgroup 3 (adjusted hazard ratios, 1.47 [1.07, 2.01] and 1.72 [1.38, 2.16], respectively). Conclusion The longitudinal investigation identified a subsequent risk of interstitial cystitis/bladder pain syndrome in patients with somatic symptoms. Somatic symptoms might be linked to biological pathways that might increase the risk of interstitial cystitis/bladder pain syndrome, much like more traditional psychosocial factors.
目的 躯体症状是伴有与这些症状不相称的想法、感受和行为的躯体主诉。本研究调查了以躯体症状为特征的五种《国际疾病分类(第九版)临床修订本》诊断。该研究假设躯体症状患者患间质性膀胱炎/膀胱疼痛综合征的风险增加。方法 原始数据来自2002年至2013年的全国健康保险报销数据库。该研究对间质性膀胱炎/膀胱疼痛综合征的躯体症状队列(n = 34393)和非躯体症状队列(n = 637999)进行了随访。根据性别、年龄和间质性膀胱炎/膀胱疼痛综合征的17种合并症计算的倾向得分,将两个队列均分为三个亚组。结果 在三个亚组中,躯体症状队列和非躯体症状队列之间的间质性膀胱炎/膀胱疼痛综合征的发病密度有显著差异(相对比率[95%置信区间]分别为2.14[1.01, 4.53]、1.52[1.47, 1.57]和1.59[1.28, 1.98])。在女性占主导的年龄较大的亚组——亚组2和亚组3中,间质性膀胱炎/膀胱疼痛综合征的调整后风险比显著更高(调整后风险比分别为1.47[1.07, 2.01]和1.72[1.38, 2.16])。结论 纵向调查发现躯体症状患者随后有患间质性膀胱炎/膀胱疼痛综合征的风险。躯体症状可能与可能增加间质性膀胱炎/膀胱疼痛综合征风险的生物学途径有关,这与更传统的心理社会因素类似。