Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea.
J Affect Disord. 2019 Oct 1;257:486-494. doi: 10.1016/j.jad.2019.07.003. Epub 2019 Jul 2.
The assessment of comorbid physical illness and metabolic or cardiovascular risk factors as potential risk factors for onset of major depressive disorder (MDD) is crucial. We aimed to investigate potential risk factors for the development of MDD among individuals with chronic medical conditions and metabolic and behavioral risk factors using a large population-based retrospective cohort from the data of the National Health Insurance Service (NHIS) in South Korea.
The population-based retrospective cohort included data from 2,370,815 adults (age ≥20 years) diagnosed with MDD between January 1, 2010, and December 31, 2016 and age- and gender-matched 2,370,815 healthy controls obtained from the claims data of the NHIS. The data of the regular health checkup provided by the NHIS were also included (age ≥40 years). Logistic regression analyses were performed to investigate the potential risk factors for the incidence of MDD.
Chronic medical conditions such as Parkinson's disease (odds ratio [OR] = 7.808, 95% confidence interval [CI] = 7.517-8.11), epilepsy (OR = 6.119, 95% CI = 6.019-6.22), multiple sclerosis (OR = 5.532, 95% CI = 4.976-6.151), Huntington's disease (OR = 5.387, 95% CI = 3.258-8.909), migraine (OR = 4.374, 95% CI = 4.341-4.408), stroke (OR = 4.074, 95% CI = 4.032-4.117), and cancer; metabolic syndrome (OR = 1.049, 95% CI = 1.041-1.057) and several of its components including central obesity, elevated fasting blood glucose and triglyceride levels, and reduced high-density lipoprotein level; and cigarette smoking, frequent alcohol consumption, and low physical activity are potential risk factors for the development of MDD.
Our results may support previous evidence on the association between physical conditions and the incidence of MDD as reported by individual population-based studies with modest sample sizes.
评估合并躯体疾病和代谢或心血管危险因素是否为发生重度抑郁症（MDD）的潜在危险因素至关重要。本研究旨在利用韩国国民健康保险服务（NHIS）的数据，通过一项大型基于人群的回顾性队列研究，调查患有慢性躯体疾病和代谢及行为危险因素的个体发生 MDD 的潜在危险因素。
该基于人群的回顾性队列纳入了 2370815 名年龄≥20 岁（2010 年 1 月 1 日至 2016 年 12 月 31 日期间诊断为 MDD）成年人的数据，以及从 NHIS 的索赔数据中按年龄和性别匹配的 2370815 名健康对照者。此外，还纳入了 NHIS 定期健康检查的数据（年龄≥40 岁）。采用 logistic 回归分析调查 MDD 发病的潜在危险因素。
慢性躯体疾病（如帕金森病[OR=7.808，95%置信区间（CI）=7.517-8.11]、癫痫[OR=6.119，95%CI=6.019-6.22]、多发性硬化症[OR=5.532，95%CI=4.976-6.151]、亨廷顿病[OR=5.387，95%CI=3.258-8.909]、偏头痛[OR=4.374，95%CI=4.341-4.408]、中风[OR=4.074，95%CI=4.032-4.117]和癌症）、代谢综合征（OR=1.049，95%CI=1.041-1.057）及其部分成分（包括中心性肥胖、空腹血糖和甘油三酯水平升高以及高密度脂蛋白水平降低），以及吸烟、频繁饮酒和体力活动水平低，均为 MDD 发病的潜在危险因素。
本研究结果可能支持此前个体人群研究的证据，这些研究的样本量较小，提示躯体状况与 MDD 发病之间存在关联。
