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慢性胰腺炎诊断后焦虑和抑郁障碍患病率的增加:一项为期 5 年的基于人群的研究。

Increasing Prevalence of Anxiety and Depression Disorders After Diagnosis of Chronic Pancreatitis: A 5-Year Population-Based Study.

机构信息

From the Departments of Internal Medicine.

Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, Cleveland, OH.

出版信息

Pancreas. 2021 Feb 1;50(2):153-159. doi: 10.1097/MPA.0000000000001746.

Abstract

OBJECTIVES

Chronic pancreatitis (CP) is often associated with poor quality of life. Only a few small associative studies have reported the prevalence of mood disorders in CP. Using a large database, we sought to describe the epidemiology and risk association of anxiety and depression in CP and evaluate their outcomes.

METHODS

A multicenter database (Explorys), an aggregate of electronic health record data from 26 US healthcare systems, was surveyed. A cohort of patients with a diagnosis of CP between 2014 and 2019 was identified. Within this cohort, rates of anxiety and depression were calculated. Demographics, comorbidities, and outcomes were described.

RESULTS

Of the 30,276,810 individuals in the database (2014-2019), 67,260 patients had a CP diagnosis (0.22%). When compared with patients with no history of CP, patients with CP were more likely to develop anxiety (odds ratio, 6.94; 95% confidence interval, 6.85-7.04) and depression (odds ratio, 5.09; 95% confidence interval, 5.01-5.17). Chronic pancreatitis patients with depression had an increased risk of suicidal ideation compared with controls.

CONCLUSIONS

Patients with CP are at a higher risk of developing anxiety and depression compared with those without CP, with overall worse outcomes. Clinicians should screen CP patients and make appropriate referral to psychiatry when indicated.

摘要

目的

慢性胰腺炎(CP)常伴有生活质量下降。仅有少数几项小型关联研究报告了 CP 患者中情绪障碍的患病率。我们使用大型数据库,旨在描述 CP 患者中焦虑和抑郁的流行病学和风险关联,并评估其结局。

方法

对一个多中心数据库(Explorys)进行了调查,该数据库是来自 26 个美国医疗保健系统的电子健康记录数据的集合。确定了 2014 年至 2019 年间诊断为 CP 的患者队列。在该队列中,计算了焦虑和抑郁的发生率。描述了人口统计学、合并症和结局。

结果

在数据库(2014-2019 年)中的 30,276,810 人中,有 67,260 名患者患有 CP(0.22%)。与无 CP 病史的患者相比,CP 患者更有可能出现焦虑(优势比,6.94;95%置信区间,6.85-7.04)和抑郁(优势比,5.09;95%置信区间,5.01-5.17)。与对照组相比,患有抑郁症的 CP 患者自杀意念的风险增加。

结论

与无 CP 患者相比,CP 患者发生焦虑和抑郁的风险更高,总体结局更差。临床医生应筛查 CP 患者,并在需要时将其转介至精神病科。

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