创伤后应激障碍与自身免疫性皮肤病的相关风险：一项全国范围内基于人群的队列研究。

Posttraumatic Stress Disorder and the Associated Risk of Autoimmune Skin Diseases: A Nationwide Population-Based Cohort Study.

机构信息

From the Department of Dermatology (Dai, Chang), Taipei Veterans General Hospital; School of Medicine (Dai, Tai, Chang, T.-J. Chen, M.-H. Chen), National Yang Ming Chiao Tung University, Taipei; Department of Anesthesiology (Tai), Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Anesthesiology (Tai), School of Medicine, College of Medicine, Taipei Medical University; Department of Family Medicine (T-.J. Chen), Taipei Veterans General Hospital; and Department of Psychiatry (M-.H. Chen), Taipei Veterans General Hospital, Taipei, Taiwan.

出版信息

Psychosom Med. 2021 Apr 1;83(3):212-217. doi: 10.1097/PSY.0000000000000920.

DOI:10.1097/PSY.0000000000000920

PMID:33587564

Abstract

OBJECTIVE

Posttraumatic stress disorder (PTSD) is known as a risk factor for various immune-related disorders; however, the association between PTSD and related autoimmune skin diseases (ASDs) remains unclear. This study aimed to investigate the association of PTSD with the risk of related ASDs.

METHODS

Participants were recruited from the National Health Insurance Research Database in Taiwan. We included 9801 patients with PTSD and 39,204 matched controls to assess the risk of developing ASDs. Cox regression model was used for analyses.

RESULTS

After adjusting for confounders, we found an increased risk of ASDs among the patients with PTSD (adjusted hazard ratio [aHR] = 3.00, 95% confidence interval [CI] = 2.21-4.07) compared with that among matched controls. Statistically significant associations were found between PTSD and five individual ASDs, including psoriasis (aHR = 3.81, 95% CI = 1.90-7.67), lichen planus (aHR = 31.63, 95% CI = 4.00-249.91), alopecia areata (aHR = 4.77, 95% CI = 2.47-9.20), autoimmune bullous diseases (aHR = 9.55, 95% CI = 1.98-45.99), and vitiligo (aHR = 16.06, 95% CI = 4.48-57.54).

CONCLUSIONS

Patients with PTSD had an increased risk of developing ASDs compared with the matched controls. Further studies are needed for better understanding of the underlying mechanisms.

摘要

目的

创伤后应激障碍（PTSD）已知是各种免疫相关疾病的危险因素；然而，PTSD 与相关自身免疫性皮肤病（ASD）之间的关联尚不清楚。本研究旨在调查 PTSD 与相关 ASD 发病风险的关系。

方法

参与者从台湾国民健康保险研究数据库中招募。我们纳入了 9801 例 PTSD 患者和 39204 例匹配对照，以评估发生 ASD 的风险。采用 Cox 回归模型进行分析。

结果

调整混杂因素后，我们发现 PTSD 患者发生 ASD 的风险增加（调整后的危险比[aHR] = 3.00，95%置信区间[CI] = 2.21-4.07），与匹配对照相比。PTSD 与五种个体 ASD 之间存在显著关联，包括银屑病（aHR = 3.81，95%CI = 1.90-7.67）、扁平苔藓（aHR = 31.63，95%CI = 4.00-249.91）、斑秃（aHR = 4.77，95%CI = 2.47-9.20）、自身免疫性大疱性疾病（aHR = 9.55，95%CI = 1.98-45.99）和白癜风（aHR = 16.06，95%CI = 4.48-57.54）。