Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Arthritis Care Res (Hoboken). 2018 Jul;70(7):970-978. doi: 10.1002/acr.23539. Epub 2018 May 21.
We estimated the incidence and prevalence of depression, anxiety disorder, bipolar disorder, and schizophrenia in a population-based cohort with rheumatoid arthritis (RA) as compared to an age-, sex-, and geographically matched cohort without RA.
Using population-based administrative health data from Manitoba, Canada, we identified persons with incident RA between 1989 and 2012, and a cohort from the general population matched 5:1 on year of birth, sex, and region of residence. We applied validated algorithms for depression, anxiety disorder, bipolar disorder, and schizophrenia to determine the annual incidence of these conditions after the diagnosis of RA, and their lifetime and annual period prevalence. We compared findings between cohorts using negative binomial regression models.
We identified 10,206 incident cases of RA and 50,960 matched individuals. After adjustment for age, sex, socioeconomic status, region of residence, number of physician visits, and year, the incidence of depression was higher in the RA cohort over the study period (incidence rate ratio [IRR] 1.46 [95% confidence interval (95% CI) 1.35-1.58]), as was the incidence of anxiety disorder (IRR 1.24 [95% CI 1.15-1.34]) and bipolar disorder (IRR 1.21 [95% CI 1.00-1.47]). The incidence of schizophrenia did not differ between groups (IRR 0.96 [95% CI 0.61-1.50]). Incidence rates of psychiatric disorders declined minimally over time. The lifetime and annual period prevalence of depression and anxiety disorder were also higher in the RA than in the matched cohort over the study period.
The incidence and prevalence of depression, anxiety disorder, and bipolar disorder are elevated in the RA population as compared to a matched population.
与未患类风湿关节炎（RA）的年龄、性别和地理位置匹配队列相比，我们评估了人群队列中患有 RA 的患者中抑郁、焦虑障碍、双相情感障碍和精神分裂症的发病率和患病率。
利用加拿大马尼托巴省基于人群的行政健康数据，我们确定了 1989 年至 2012 年间患有 RA 的新发患者，并确定了一个与出生年份、性别和居住地相匹配的普通人群队列，匹配比例为 5：1。我们应用了经过验证的抑郁、焦虑障碍、双相情感障碍和精神分裂症的算法，以确定 RA 诊断后这些疾病的年度发病率及其终生和年度流行率。我们使用负二项回归模型比较了队列之间的结果。
我们确定了 10206 例 RA 新发病例和 50960 例匹配个体。调整年龄、性别、社会经济地位、居住地、就诊次数和年份后，RA 队列在研究期间的抑郁发病率较高（发病率比 [IRR] 1.46 [95%置信区间 95%CI 1.35-1.58]），焦虑障碍（IRR 1.24 [95%CI 1.15-1.34]）和双相情感障碍（IRR 1.21 [95%CI 1.00-1.47]）也是如此。两组之间的精神分裂症发病率没有差异（IRR 0.96 [95%CI 0.61-1.50]）。随着时间的推移，精神病发病率略有下降。在研究期间，RA 队列的抑郁和焦虑障碍终生和年度流行率也高于匹配队列。
与匹配队列相比，RA 人群的抑郁、焦虑障碍和双相情感障碍的发病率和患病率更高。
