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男性性心理障碍患者的精神疾病发病风险:台湾一项全国性队列研究。

Risk of Psychiatric Morbidity in Psychosexual Disorders in Male Patients: A Nationwide, Cohort Study in Taiwan.

机构信息

1 Department of Psychiatry, School of Medicine, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.

2 Student Counseling Center, National Defense Medical Center, Taipei, Republic of China.

出版信息

Am J Mens Health. 2019 Mar-Apr;13(2):1557988319842985. doi: 10.1177/1557988319842985.

Abstract

This study aimed to investigate the association between males with psychosexual disorders (PSDs) and the risk of developing psychiatric disorders. A total of 34,972 enrolled patients, with 8,743 subjects who had suffered from PSD and 26,229 controls (1:3) matched for age and index year, from Taiwan's Longitudinal Health Insurance Database (LHID) from 2000 to 2015, selected from the National Health Insurance Research Database (NHIRD). After adjusting all the confounding factors, the multivariate Cox regression model was used to compare the risk of developing psychiatric disorders, between the PSD and non-PSD groups, during the 15 years of follow-up. Of the all enrollees, 1,113 in the PSD cohort and 2,611 in the non-PSD cohort (1,180.96 vs. 954.68 per 100,000 person-year) developed psychiatric disorders. Multivariate Cox regression model survival analysis revealed that, after adjusting for gender, age, monthly income, urbanization level, geographic region, and comorbidities, the adjusted hazard ratio (HR) was 2.448 (95% CI [2.227, 2.633], p < .001). PSD has been associated with the increased risk in anxiety disorders, depressive disorders, bipolar disorders, sleep disorders, and psychotic disorders, respectively. Sexual dysfunctions, paraphilia, and gender identity disorders were associated with the overall psychiatric disorders with adjusted HRs as 1.990 ( p < .001), 11.622 ( p < .001), and 5.472 ( p < .001), respectively. Male patients who suffered from PSD have a higher risk of developing psychiatric disorders, and this finding should be considered as a timely reminder for the clinicians to provide much more attention for these patients because of their mental health issues.

摘要

本研究旨在探讨男性精神性性功能障碍(PSD)与精神障碍发病风险之间的关系。我们从台湾全民健康保险研究数据库(NHIRD)中,选择了 2000 年至 2015 年期间来自纵向健康保险数据库(LHID)的 34972 名登记患者,共 8743 名患者患有 PSD,26229 名对照(1:3)按年龄和索引年份匹配。调整所有混杂因素后,采用多变量 Cox 回归模型比较 PSD 组和非 PSD 组在 15 年随访期间发生精神障碍的风险。在所有入组者中,PSD 队列中有 1113 人,非 PSD 队列中有 2611 人(1180.96 比 954.68/100000 人年)发生了精神障碍。多变量 Cox 回归模型生存分析显示,调整性别、年龄、月收入、城市化水平、地理区域和合并症后,调整后的危险比(HR)为 2.448(95%CI[2.227,2.633],p<.001)。PSD 与焦虑障碍、抑郁障碍、双相情感障碍、睡眠障碍和精神病性障碍的风险增加分别相关。性机能障碍、性癖好和性别认同障碍与总体精神障碍分别相关,调整后的 HR 分别为 1.990(p<.001)、11.622(p<.001)和 5.472(p<.001)。患有 PSD 的男性患者发生精神障碍的风险更高,这一发现应引起临床医生的重视,因为这些患者存在心理健康问题,需要给予更多关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d14/6460890/52c62c28ef69/10.1177_1557988319842985-fig1.jpg

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