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社区居住的帕金森病患者和非帕金森病患者中抗抑郁药物使用的发生率 - 一项全国性队列研究。

Incidence of antidepressant use among community dwellers with and without Parkinson's disease - a nationwide cohort study.

机构信息

School of Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.

Kuopio Research Centre of Geriatric Care, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.

出版信息

BMC Geriatr. 2021 Mar 23;21(1):202. doi: 10.1186/s12877-021-02145-6.

Abstract

BACKGROUND

Antidepressant use is more common in people with Parkinson's disease (PD), but it is unknown when this difference emerges.

METHODS

We studied the incidence of antidepressant use in six-month periods from 10 years before to 15 years after PD diagnosis in the nationwide register-based Finnish Study on Parkinson's disease (FINPARK). This study included 20,456 community dwellers with clinically verified PD diagnosed during 1996-2015 and 140,291 matched comparison persons.

RESULTS

Altogether 44.3% of people with PD initiated antidepressants, compared to 25.0% of people without PD. The difference was largest 6 months before PD diagnosis (incidence rate ratio 5.28, 95% CI 4.80-5.80; 9.02 and 1.68 initiations/100 person-years in people with and without PD, respectively). The difference emerged already 7 years before the diagnosis and remained above the comparison group for most of the study period.

CONCLUSIONS

Persons with PD may have symptoms that require antidepressant treatment years before and after diagnosis. The symptoms needing antidepressant treatment may be clinical signs of possible PD and they should be considered as a need to assess clinical status in person diagnosed with PD.

摘要

背景

在帕金森病(PD)患者中,抗抑郁药的使用更为常见,但尚不清楚这种差异何时出现。

方法

我们在基于全国注册的芬兰帕金森病研究(FINPARK)中,研究了 PD 诊断前 10 年至后 15 年内的六个月时间段内抗抑郁药的使用发生率。该研究包括 20456 名居住在社区的、经临床确诊的 PD 患者,以及 140291 名匹配的对照者。

结果

共有 44.3%的 PD 患者开始使用抗抑郁药,而无 PD 的患者为 25.0%。在 PD 诊断前 6 个月差异最大(发病率比 5.28,95%CI 4.80-5.80;PD 患者和无 PD 患者的起始人数分别为 9.02 和 1.68/100 人年)。这种差异早在诊断前 7 年就已经出现,并在研究期间的大部分时间内仍高于对照组。

结论

PD 患者可能在诊断前后多年就有需要抗抑郁治疗的症状。需要抗抑郁治疗的症状可能是 PD 的临床迹象,应将其视为确诊 PD 患者需要评估临床状况的一个指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4184/7986562/4b036ace67e1/12877_2021_2145_Fig1_HTML.jpg

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