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新发 2 型糖尿病患者的药物诱发精神障碍治疗及精神病院接触情况——基于登记的队列研究。

Incident psychopharmacological treatment and psychiatric hospital contact in individuals with newly developed type 2 diabetes - a register-based cohort study.

机构信息

Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark.

Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

出版信息

Acta Neuropsychiatr. 2021 Apr;33(2):72-84. doi: 10.1017/neu.2020.39. Epub 2020 Oct 28.

Abstract

To investigate the association between newly developed type 2 diabetes (T2D) and incident psychopharmacological treatment and psychiatric hospital contact. Via Danish registers, we identified all 56 640 individuals from the Central and Northern Denmark Regions with newly developed T2D (defined by the first HbA1c measurement ≥6.5%) in 2000-2016 as well as 315 694 age- and sex-matched controls (without T2D). Those having received psychopharmacological treatment or having had a psychiatric hospital contact in the 5 years prior to the onset of T2D were not included. For this cohort, we first assessed the 2-year incidence of psychopharmacological treatment and psychiatric hospital contact. Secondly, via Cox regression, we compared the incidence of psychopharmacological treatment/psychiatric hospital contact among individuals with T2D to propensity score-matched controls - taking a wide range of potential confounders into account. Finally, via Cox proportional hazards regression, we assessed which baseline (T2D onset) characteristics were associated with subsequent psychopharmacological treatment and psychiatric hospital contact. A total of 8.3% of the individuals with T2D initiated psychopharmacological treatment compared to 4.6% of the age- and sex-matched controls. Individuals with T2D were at increased risk of initiating psychopharmacological treatment compared to the propensity score-matched controls (HR = 1.51, 95% CI = 1.43-1.59), whereas their risk of psychiatric hospital contact was not increased to the same extent (HR = 1.14, 95% CI = 0.98-1.32). Older age, somatic comorbidity, and being divorced/widowed were associated with both psychopharmacological treatment and psychiatric hospital contact following T2D. Individuals with T2D are at elevated risk of requiring psychopharmacological treatment.

摘要

目的

研究新诊断 2 型糖尿病(T2D)与精神药理学治疗和精神病院接触的相关性。

方法

通过丹麦登记处,我们确定了来自丹麦中部和北部地区的 56640 名在 2000-2016 年间新诊断出 T2D(根据首次 HbA1c 测量≥6.5%定义)的个体,以及 315694 名年龄和性别匹配的对照者(无 T2D)。在 T2D 发病前 5 年内接受过精神药理学治疗或有过精神病院接触的患者不包括在内。对于该队列,我们首先评估了 2 年内精神药理学治疗和精神病院接触的发生率。其次,通过 Cox 回归,我们比较了 T2D 患者与倾向评分匹配对照者的精神药理学治疗/精神病院接触发生率,同时考虑了广泛的潜在混杂因素。最后,通过 Cox 比例风险回归,我们评估了哪些基线(T2D 发病)特征与随后的精神药理学治疗和精神病院接触有关。与年龄和性别匹配的对照组相比,T2D 患者开始精神药理学治疗的比例为 8.3%,而对照组为 4.6%。与倾向评分匹配的对照组相比,T2D 患者开始精神药理学治疗的风险增加(HR=1.51,95%CI=1.43-1.59),但精神病院接触的风险增加程度则没有那么大(HR=1.14,95%CI=0.98-1.32)。年龄较大、躯体合并症和离婚/丧偶与 T2D 后精神药理学治疗和精神病院接触均相关。T2D 患者需要精神药理学治疗的风险增加。

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