Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan; Division of Infection and Pathway Medicine, College of Medicine and Veterinary Medicine, the University of Edinburgh, Scotland, UK.
Department of Obstetrics & Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Psychiatry Res. 2017 Nov;257:14-20. doi: 10.1016/j.psychres.2017.07.013. Epub 2017 Jul 8.
Both scabies and bipolar disorder (BD) are common and troublesome disorders. There are several similarities in both diseases: pruritus, a higher prevalence in crowded environments, and cytokine-mediated inflammatory processes in the pathophysiology. We conducted this nationwide population-based study to investigate the possible relationship between scabies and BD. Based on the National Health Insurance Research Database (NHIRD) of Taiwan, a total of 7096 patients with scabies were identified as a study group and 28,375 matched patients as a control. We tracked the patients in both groups for a 7-year period to identify those newly diagnosed with BD. The demographic characteristics and comorbidities of the patients were analyzed, and Cox proportional hazard regressions were performed to calculate the hazard ratio (HR) of BD. Of the 35,471 patients in this study, 183 (0.5%) patients with newly diagnosed BD were identified, with 58 (0.8%) from the scabies group and 125 (0.4%) from the control group. The patients with scabies had a higher risk of subsequent BD, with a crude hazard ratio of 1.86 and an adjusted hazard ratio of 1.55 (95% confidence interval: 1.12-2.09, P < 0.05). This study shows there is an increased risk for BD among patients with scabies. Immunopathology may contribute to this association.
疥疮和双相情感障碍（BD）都是常见且麻烦的疾病。这两种疾病有几个相似之处：瘙痒、在拥挤环境中发病率较高，以及在病理生理学中细胞因子介导的炎症过程。我们进行了这项全国性的基于人群的研究，以调查疥疮和 BD 之间可能存在的关系。基于台湾的全民健康保险研究数据库（NHIRD），共确定了 7096 例疥疮患者作为研究组，28375 例匹配患者作为对照组。我们对两组患者进行了为期 7 年的跟踪，以确定那些新诊断为 BD 的患者。分析了患者的人口统计学特征和合并症，并进行了 Cox 比例风险回归，以计算 BD 的风险比（HR）。在这项研究中，共有 35471 例患者，其中 183 例（0.5%）新诊断为 BD，其中 58 例（0.8%）来自疥疮组，125 例（0.4%）来自对照组。患有疥疮的患者发生 BD 的风险更高，粗风险比为 1.86，调整后的风险比为 1.55（95%置信区间：1.12-2.09，P<0.05）。这项研究表明，疥疮患者发生 BD 的风险增加。免疫病理学可能促成了这种关联。
