Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, South Korea.
J Affect Disord. 2019 May 15;251:256-262. doi: 10.1016/j.jad.2019.03.059. Epub 2019 Mar 20.
Recently, a bidirectional association between Bell's palsy and anxiety disorders has been reported. Given the common comorbidity between anxiety and depressive conditions and the typical developmental trajectory of anxiety before depression, we hypothesized that the bidirectional association between Bell's palsy and depression is also reproducible.
Using data from the Korean National Health Insurance Service-National Sample Cohort, data were collected from 3,526 Bell's palsy patients who were 1:4 matched by age, sex, income, region of residence, and past medical history with 14,104 controls. Additionally, 61,068 depression patients were matched with 244,272 control participants. A Cox proportional hazards model was used to analyze the hazard ratio (HR) of Bell's palsy for depression (study I) and depression for Bell's palsy (study II).
In study I, the adjusted HR for depression was 1.41 (95% confidence interval [CI] = 1.20-1.66) in the Bell's palsy group (P < 0.001). In subgroup analyses, an increased risk of depression was more evident, particularly in female participants ≥ 40 years old. This association was evident in follow-up periods 6 months after the index date. In study II, the adjusted HR for Bell's palsy was 1.08 (95% CI = 0.94-1.25) in the depression group (P = 0.280).
A history of Bell's palsy increased the risk of depression. Contrary to our hypotheses, depression did not increase the risk of Bell's palsy.
最近有报道称贝尔麻痹与焦虑障碍之间存在双向关联。鉴于焦虑和抑郁障碍之间存在共同的共病性，以及焦虑在抑郁之前的典型发展轨迹，我们假设贝尔麻痹与抑郁之间的双向关联也是可复制的。
使用来自韩国国家健康保险服务-国家样本队列的数据，我们从 3526 名贝尔麻痹患者中收集数据，这些患者按年龄、性别、收入、居住地区和既往病史与 14104 名对照进行 1：4 匹配；此外，61068 名抑郁症患者与 244272 名对照参与者相匹配。采用 Cox 比例风险模型分析贝尔麻痹发生抑郁的风险比（HR）（研究 I）和抑郁发生贝尔麻痹的 HR（研究 II）。
在研究 I 中，在贝尔麻痹组中，抑郁的调整后 HR 为 1.41（95%置信区间[CI] = 1.20-1.66）（P<0.001）。在亚组分析中，女性≥40 岁的参与者中，抑郁的风险增加更为明显。这种关联在指数日期后 6 个月的随访期内更为明显。在研究 II 中，在抑郁组中，贝尔麻痹的调整后 HR 为 1.08（95%CI = 0.94-1.25）（P=0.280）。
贝尔麻痹病史增加了患抑郁的风险。与我们的假设相反，抑郁并未增加患贝尔麻痹的风险。
