Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Nursing, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Niaosong, Kaohsiung, Taiwan.
J Clin Nurs. 2018 Mar;27(5-6):e1038-e1047. doi: 10.1111/jocn.14139. Epub 2018 Feb 6.
To predict the risk factors related to newly diagnosed psychiatric disorders resulting from spinal cord injuries (SCIs).
SCIs are a common result of devastating accidents; they can have an essential negative impact on the psychological health of those so afflicted. Psychiatric disorders commonly occur worldwide and are often associated with pain and disability; however, few studies have investigated the risk factors of psychiatric disorders among persons with SCIs.
A retrospective cohort study design with data obtained from the Taiwan Health Insurance Research Database (THIRD). THIRD involves the claims data on recipients recorded in the Taiwan National Health Insurance (TNHI), which was set up in 1995 and covers about 99% of the 23 million persons in Taiwan.
We used THIRD to predict the risk factors related to newly diagnosed psychiatric disorders among victims of spinal cord injury.
The majority of persons with SCI were men (51.2%), and their average age was 52.8 years. All 5,828 newly diagnosed psychiatric disorders were included from 1997-2009 in 64,907 SCI in the THIRD data set. These results demonstrated notable differences in hazard risk (HR); the injured persons were inspected for the level of SCI, age, hypertension and chronic obstructive pulmonary disease (HR: 1.637, 95% CI: 1.452-1.844, p < .0001; HR: 1.005, 95% CI: 1.002-1.009, p = .0019; HR: 0.724, 95% CI: 0.642-0.816; HR: 1.267, 95% CI: 1.105-1.454, p = .0007; HR: 1.368, 95% CI: 1.183-1.582, p < .0001, respectively); the persons with SCI exhibited significant independent associations with psychiatric disorders.
The results revealed that the level of SCI, female gender and age, respectively, affects the incidence of newly diagnosed psychiatric disorder related to SCI.
This study showed that psychiatric disorders may be associated with the development of SCI, and that this risk was more predominant in females with SCI. Our results are of direct clinical relevance as they are meant to assist clinical assessment, counselling, guidance of symptomatic monitoring and early clinical intervention.
预测与脊髓损伤（SCI）相关的新诊断精神障碍的相关风险因素。
SCI 是毁灭性事故的常见后果；它们会对受影响者的心理健康产生重大负面影响。精神障碍在全球范围内普遍存在，通常与疼痛和残疾有关；然而，很少有研究调查 SCI 患者精神障碍的风险因素。
使用来自台湾健康保险研究数据库（THIRD）的数据进行回顾性队列研究设计。THIRD 包括 1995 年建立的台湾全民健康保险（TNHI）中记录的受保人的索赔数据，该保险涵盖了台湾 2300 万人中的约 99%。
我们使用 THIRD 预测脊髓损伤受害者新诊断精神障碍的相关风险因素。
大多数 SCI 患者为男性（51.2%），平均年龄为 52.8 岁。在 THIRD 数据集中，从 1997 年至 2009 年，共纳入了 64907 例 SCI 中的 5828 例新诊断的精神障碍。这些结果显示出显著的危险风险差异（HR）；对 SCI 水平、年龄、高血压和慢性阻塞性肺疾病（HR：1.637，95%CI：1.452-1.844，p<.0001；HR：1.005，95%CI：1.002-1.009，p=.0019；HR：0.724，95%CI：0.642-0.816；HR：1.267，95%CI：1.105-1.454，p=.0007；HR：1.368，95%CI：1.183-1.582，p<.0001）进行了检查。SCI 患者与精神障碍有显著的独立关联。
结果表明，SCI 水平、女性性别和年龄分别影响与 SCI 相关的新诊断精神障碍的发生率。
本研究表明，精神障碍可能与 SCI 的发生有关，而这种风险在 SCI 女性中更为明显。我们的研究结果具有直接的临床相关性，因为它们旨在协助临床评估、咨询、症状监测指导和早期临床干预。
