Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, ROC.
Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, ROC; School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
J Neurol Sci. 2017 Oct 15;381:88-94. doi: 10.1016/j.jns.2017.08.022. Epub 2017 Aug 18.
Guillain-Barre syndrome (GBS) is a rare immune-related neurological disorder with high mortality and morbidity, but the comorbid psychiatric disorders garnered little attention in the GBS patients. This study aimed to investigate the association between GBS and the risk of developing psychiatric disorders.
A total of 18,192 enrolled patients, with 4548 study subjects who had suffered GBS, and 13,644 controls matched for gender and age, from the Inpatient Dataset of 2000-2013 in Taiwan, and selected from the National Health Insurance Research Database (NHIRD). After adjusting for confounding factors, Cox proportional hazards analysis was used to compare the risk of developing psychiatric disorders during the 13years of follow-up.
Of the study subjects, 471 (10.35%) developed psychiatric disorders when compared to 1023 (7.50%) in the control group. Fine and Gray's competing risk model analysis revealed that the study subjects were more likely to develop psychiatric disorders (crude hazard ratio [HR]: 4.281 (95% CI=3.819-4.798, p<0.001). After adjusting for gender, age, monthly income, urbanization level, geographic region, and comorbidities, the adjusted HR was 4.320 (95% CI=3.852-4.842, p<0.001). Dementia, depressive disorders, sleep disorders, and psychotic disorders predominate in these psychiatric disorders. Mechanical ventilation and hemodialysis are associated with a lower risk of dementia when compared to the control groups.
Patients who suffered from GBS had a higher risk of developing psychiatric disorders, and this finding should act as a reminder to the clinicians that a regular psychiatric follow-up might well be needed for those patients.
吉兰-巴雷综合征（GBS）是一种罕见的免疫相关性神经系统疾病，死亡率和发病率都很高，但 GBS 患者的合并精神疾病并未引起太多关注。本研究旨在探讨 GBS 与发生精神障碍风险之间的关系。
共纳入 18192 例患者，其中 4548 例研究对象患有 GBS，13644 例对照者按性别和年龄匹配，均来自台湾 2000-2013 年住院患者数据集，从国家健康保险研究数据库（NHIRD）中选取。在调整混杂因素后，采用 Cox 比例风险分析比较了 13 年随访期间发生精神障碍的风险。
与对照组相比，研究对象中有 471 例（10.35%）发生了精神障碍，1023 例（7.50%）。Fine 和 Gray 竞争风险模型分析显示，研究对象发生精神障碍的风险更高（粗危险比[HR]：4.281（95%CI=3.819-4.798，p<0.001）。在调整性别、年龄、月收入、城市化水平、地理区域和合并症后，调整后的 HR 为 4.320（95%CI=3.852-4.842，p<0.001）。这些精神障碍以痴呆、抑郁障碍、睡眠障碍和精神病性障碍为主。与对照组相比，机械通气和血液透析与痴呆风险降低相关。
患有 GBS 的患者发生精神障碍的风险较高，这一发现提醒临床医生，这些患者可能需要定期进行精神科随访。
