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重度抑郁症与随后发生的自身免疫性皮肤病之间的关联:一项全国范围内基于人群的队列研究。

Association between major depressive disorder and subsequent autoimmune skin diseases: A nationwide population-based cohort study.

机构信息

Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.

School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

出版信息

J Affect Disord. 2020 Sep 1;274:334-338. doi: 10.1016/j.jad.2020.05.070. Epub 2020 May 25.

Abstract

BACKGROUND

Major depressive disorder (MDD) has been implicated as a risk factor for various immune-related disorders; however, the association between MDD and subsequent autoimmune skin diseases (ASDs) remains unclear. This study aimed to investigate the association of MDD with risk of subsequent ASDs.

METHODS

Subjects were recruited from the National Health Insurance Research Database in Taiwan. We included 222,522 patients with MDD and 890,088 matched controls to assess the risk of developing ASDs.

RESULTS

After controlling for confounders, we found an increased risk of ASDs among the patients with MDD (adjusted hazard ratio [aHR], 10.41; 95% CI, 9.62-11.42) compared to matched controls. Subgroup analyses showed that MDD patients had a significantly increased risk of developing psoriasis (aHR, 12.01; 95% CI, 10.37-13.91), lichen planus (aHR, 11.84; 95% CI, 8.90-15.75), alopecia areata (aHR, 11.61; 95% CI, 9.92-13.59), morphea (aHR, 6.03; 95% CI, 2.47-14.73), autoimmune bullous diseases (aHR, 7.67; 95% CI, 5.94-9.90), hidradenitis suppurativa (aHR, 8.45; 95% CI, 3.61-19.74), vitiligo (aHR, 7.24; 95% CI, 5.65-9.28), lupus erythematosus (aHR, 11.30; 95% CI, 9.21-13.86), systemic sclerosis (aHR, 8.07; 95% CI, 4.30-15.14), Sjogren's syndrome (aHR, 6.71; 95% CI, 5.29-8.50), and dermatomyositis (aHR, 14.44; 95% CI, 5.55-37.55).

CONCLUSIONS

Patients with MDD had an increased risk of developing ASDs as compared to the controls. Further studies are needed to better understand the underlying mechanisms.

摘要

背景

重度抑郁症(MDD)已被认为是各种与免疫相关疾病的危险因素;然而,MDD 与随后发生的自身免疫性皮肤病(ASD)之间的关联尚不清楚。本研究旨在探讨 MDD 与 ASD 风险的相关性。

方法

研究对象来自中国台湾的全民健康保险研究数据库。我们纳入了 222522 例 MDD 患者和 890088 例匹配对照,以评估发生 ASD 的风险。

结果

在控制混杂因素后,与匹配对照相比,MDD 患者发生 ASD 的风险增加(调整后的危险比[aHR],10.41;95%CI,9.62-11.42)。亚组分析显示,MDD 患者发生银屑病(aHR,12.01;95%CI,10.37-13.91)、扁平苔藓(aHR,11.84;95%CI,8.90-15.75)、斑秃(aHR,11.61;95%CI,9.92-13.59)、硬斑病(aHR,6.03;95%CI,2.47-14.73)、自身免疫性大疱性疾病(aHR,7.67;95%CI,5.94-9.90)、化脓性汗腺炎(aHR,8.45;95%CI,3.61-19.74)、白癜风(aHR,7.24;95%CI,5.65-9.28)、红斑狼疮(aHR,11.30;95%CI,9.21-13.86)、系统性硬化症(aHR,8.07;95%CI,4.30-15.14)、干燥综合征(aHR,6.71;95%CI,5.29-8.50)和皮肌炎(aHR,14.44;95%CI,5.55-37.55)的风险均增加。

结论

与对照组相比,MDD 患者发生 ASD 的风险增加。需要进一步的研究来更好地了解潜在的机制。

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