多发性硬化症患者患精神疾病的风险：一项针对亚洲人群的全国性队列研究。
Risk of Psychiatric Disorders in Multiple Sclerosis: A Nationwide Cohort Study in an Asian Population.
作者信息
Huang Yao-Ching, Chien Wu-Chien, Chung Chi-Hsiang, Chang Hsin-An, Kao Yu-Chen, Wan Fang-Jung, Huang Shi-Hao, Chung Ren-Jei, Wang Richard S, Wang Bing-Long, Tzeng Nian-Sheng, Sun Chien-An
机构信息
Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan.
School of Public Health, National Defense Medical Center, Taipei, Taiwan.
出版信息
Neuropsychiatr Dis Treat. 2021 Feb 22;17:587-604. doi: 10.2147/NDT.S268360. eCollection 2021.
BACKGROUND
Multiple sclerosis (MS) is a demyelinating disease that can damage neurons in the brain and spinal cord and is associated with several psychiatric disorders. However, few studies have evaluated the risk of psychiatric disorders in patients with MS by using a nationwide database. This study investigated the association between MS and the risk of psychiatric disorders.
METHODS
Using data from the Taiwan National Health Insurance Research Database from 2000 to 2015, we identified 1066 patients with MS. After adjustment for confounding factors, Fine and Gray's competing risk model was used to compare the risk of psychiatric disorders during 15 years of follow-up.
RESULTS
Of the patients with MS, 531 (4622.86 per 10 person years) developed psychiatric disorders; by contrast, 891 of the 3198 controls (2485.31 per 10 person years) developed psychiatric disorders. Fine and Gray's competing risk model revealed an adjusted hazard ratio (HR) of 5.044 (95% confidence interval = 4.448-5.870, < 0.001) after adjustment for all the covariates. MS was associated with depression, anxiety, bipolar disorder, sleep disorders, schizophrenia, schizophreniform disorder, and other psychotic disorders (adjusted HR: 12.464, 4.650, 6.987, 9.103, 2.552, 2.600, 2.441, and 2.574, respectively; all p < 0.001). Some disease-modifying drugs were associated with a lower risk of anxiety or depression.
CONCLUSION
Patients with MS were determined to have a higher risk of developing a wide range of psychiatric disorders.
背景
多发性硬化症（MS）是一种脱髓鞘疾病，可损害大脑和脊髓中的神经元，并与多种精神障碍相关。然而，很少有研究使用全国性数据库评估MS患者患精神障碍的风险。本研究调查了MS与精神障碍风险之间的关联。
方法
利用2000年至2015年台湾国民健康保险研究数据库的数据，我们确定了1066例MS患者。在对混杂因素进行调整后，使用Fine和Gray的竞争风险模型比较15年随访期间精神障碍的风险。
结果
在MS患者中，531例（每10人年4622.86例）出现精神障碍；相比之下，3198名对照中有891例（每10人年2485.31例）出现精神障碍。Fine和Gray的竞争风险模型显示，在对所有协变量进行调整后，调整后的风险比（HR）为5.044（95%置信区间=4.448-5.870，<0.001）。MS与抑郁症、焦虑症、双相情感障碍、睡眠障碍、精神分裂症、精神分裂症样障碍和其他精神障碍相关（调整后的HR分别为：12.464、4.650、6.987、9.103、2.552、2.600、2.441和2.574；所有p<0.001）。一些疾病修正药物与较低的焦虑或抑郁风险相关。
结论
MS患者被确定患多种精神障碍的风险较高。
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