Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Xitun Dist, Taichung, 40705, Taiwan, Republic of China.
Graduate institute of biomedical sciences, China Medical University, Taichung, Taiwan, Republic of China.
BMC Ophthalmol. 2020 Mar 30;20(1):123. doi: 10.1186/s12886-020-01395-z.
Several previous studies reported a greater prevalence of dry eye syndrome (DES) among patients with psychiatric diseases. The aim of this study is to investigate the prevalence and risk factors of DES in patients with psychiatric disorders (PD) using nationwide population-based data in Taiwan.
This population-based cohort study retrospectively identified patients with PD from 1997 to 2011. Patients with both PD and DES served as the DES cohort, and PD patients without DES comprised the non-DES cohort. PD was defined as a diagnosis of PD (ICD-9-CM 290-319) made by psychiatrists only, with at least three consecutive outpatient visits or at least one inpatient visit. DES was defined as a diagnosis of DES (ICD-9-CM 375.15) and a prescription for an eye lubricant (anatomical therapeutic chemical code, ATC code: S01XA). The main outcome measures were the prevalence of DES in these patients and associated risk factors.
A total of 75,650 patients with PD (3665 in the DES cohort and 71,985 in the non-DES cohort) were included in the final analysis. The majority of patients in the DES group were women (72.6%), compared the non-DES group (57.8%). The mean age of patients in the DES cohort was 62.2 ± 14.9, which was significantly older than those in the non-DES group (50.9 ± 17.5). The patients with DES had a significantly greater likelihood of having dementia, bipolar disorder, depression, and neurotic disorders. Conditional regression analyses revealed that patients with dry eye disease were more likely to have schizophrenia (OR = 1.34), bipolar disorder (OR = 1.9), depression (OR = 1.54), and neurotic disorders (OR = 1.62). In addition, patients with DES were more likely to use 1st generation anti-psychotics (OR = 1.28) and had a lower risk of using 2nd generation anti-psychotics (OR = 0.64).
The study demonstrated that among PD patients, DES is highly prevalence in certain subtypes of PD, such as depression, bipolar disorder, and neurotic disorders, after adjusting for the comorbidities.
几项先前的研究报告称，精神病患者干眼症（DES）的患病率更高。本研究旨在利用台湾全国性基于人群的数据，调查精神疾病患者（PD）中 DES 的患病率和危险因素。
本基于人群的队列研究回顾性地确定了 1997 年至 2011 年间患有 PD 的患者。同时患有 PD 和 DES 的患者为 DES 队列，而无 DES 的 PD 患者为非 DES 队列。PD 定义为精神科医生诊断的 PD（ICD-9-CM 290-319），至少连续三次门诊就诊或至少一次住院就诊。DES 定义为 DES（ICD-9-CM 375.15）的诊断和眼润滑剂（解剖治疗化学代码，ATC 代码：S01XA）的处方。主要观察指标为这些患者中 DES 的患病率和相关危险因素。
共有 75650 例 PD 患者（DES 组 3665 例，非 DES 组 71985 例）纳入最终分析。DES 组患者以女性为主（72.6%），而非 DES 组患者以女性为主（57.8%）。DES 组患者的平均年龄为 62.2±14.9 岁，明显高于非 DES 组（50.9±17.5 岁）。DES 组患者发生痴呆、双相情感障碍、抑郁症和神经症的可能性显著增加。条件回归分析显示，患有干眼症的患者更有可能患有精神分裂症（OR=1.34）、双相情感障碍（OR=1.9）、抑郁症（OR=1.54）和神经症（OR=1.62）。此外，DES 组患者使用第一代抗精神病药物的可能性更高（OR=1.28），使用第二代抗精神病药物的风险较低（OR=0.64）。
本研究表明，在调整合并症后，PD 患者中 DES 在某些特定类型的 PD 中，如抑郁症、双相情感障碍和神经症中，患病率较高。
