Department of Mental Health, Ningbo First Hospital, 59 Liuting Road, Ningbo 315010, China; Ningbo University School of Medicine, 818 Fenghua Road, Ningbo 315211, China.
Department of Respiratory Medicine, Ningbo First Hospital, 59 Liuting Road, Ningbo 315010, China.
J Affect Disord. 2018 Oct 1;238:458-464. doi: 10.1016/j.jad.2018.05.007. Epub 2018 May 15.
Several studies were conducted to investigate the association between eczema and risk of depression. This was important because the care of patients with eczema might be inadequate if their psychological problems were not also recognized and treated. However, these studies had some inherent limitations such as small sample sizes or lack of controlling for potential confounders. Further, little was known about psychological co-morbidity of eczema from a global perspective.
We conducted a systematic literature search in PubMed (1966 through January 26th 2017), Cochrane Library (the Cochrane central register of controlled trials, up to January 26th 2017), Scopus (up to December 31st 2016) and Embase (1980 through January 26th 2017) supplemented by manual searches of bibliographies and conference proceedings. The relative risk (RR) with 95% confidence interval (CI) was estimated.
Ten studies with a total of 188,495 patients were included. Overall, the random effects model summarizing all comparisons suggested a positive association between eczema and risk of depression, the pooled RR was 2.02 (95% confidence interval 1.76 to 2.31, I² = 33.7%). Similar results were observed in subgroup analysis by region.
Methodological limitations such as selection biases, sample sizes, severity of other diseases, treatment strategy, age and other factors might have influenced the results.
Our study showed that patients with eczema were associated with an increased risk of depression. These findings implicated that clinical doctors should continue to be more aware of the association between eczema and the risk of depression.
有几项研究旨在探讨湿疹与抑郁风险之间的关联。这一点很重要，因为如果患者的心理问题没有得到识别和治疗，那么他们的湿疹护理可能就不充分。然而，这些研究存在一些固有的局限性，例如样本量小或缺乏对潜在混杂因素的控制。此外，从全球角度来看，人们对湿疹的心理共病知之甚少。
我们在 PubMed（1966 年至 2017 年 1 月 26 日）、Cochrane 图书馆（Cochrane 对照试验中心注册库，截至 2017 年 1 月 26 日）、Scopus（截至 2016 年 12 月 31 日）和 Embase（1980 年至 2017 年 1 月 26 日）进行了系统文献检索，并通过手动搜索参考文献和会议记录进行了补充。采用相对风险（RR）及其 95%置信区间（CI）进行估计。
共纳入 10 项研究，总计 188495 例患者。总体而言，汇总所有比较的随机效应模型表明，湿疹与抑郁风险之间存在正相关，合并 RR 为 2.02（95%CI 为 1.76 至 2.31，I²=33.7%）。按地区进行亚组分析也得到了类似的结果。
方法学上的局限性，如选择偏倚、样本量、其他疾病的严重程度、治疗策略、年龄和其他因素，可能影响了结果。
我们的研究表明，湿疹患者发生抑郁的风险增加。这些发现表明，临床医生应继续更加注意湿疹与抑郁风险之间的关联。
