Loosen Sven H, Kandler Jennis, Luedde Tom, Kostev Karel, Roderburg Christoph
Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Epidemiology, IQVIA, Frankfurt, Germany.
PLoS One. 2021 Apr 30;16(4):e0250503. doi: 10.1371/journal.pone.0250503. eCollection 2021.
Achalasia represents a chronic motility disorder of the esophagus featuring an impaired lower esophageal sphincter relaxation and loss of esophageal peristalsis. By causing dysphagia, regurgitation, aspiration and chest pain, achalasia might tremendously affect life quality of patients. However, the impact of achalasia on the development of mood disorders including depression has largely remained unclear. The aim of this study was to evaluate the incidence of depression in achalasia patients.
We analyzed a large primary care cohort database in Germany capturing data from 7.49 million patients.
A total of n = 1,057 patients with achalasia diagnosed between January 2005 and December 2018 were matched to a cohort of n = 3,171 patients without achalasia controlling for age, sex, physician, index year, and the Charlson comorbidity index. Interestingly, while the frequency of depression prior to the diagnosis of achalasia was comparable in both groups, new diagnoses of depression were significantly higher within one year after the diagnosis of achalasia compared to the control group, suggesting a direct and previously unrecognized association between achalasia and depression.
Our data suggest that the clinical management of patients with achalasia should include a careful and structured work-up for mood disorders in order to improve long-term quality of life in these patients.
贲门失弛缓症是一种食管慢性动力障碍性疾病，其特征为食管下括约肌松弛受损和食管蠕动消失。贲门失弛缓症可导致吞咽困难、反流、误吸和胸痛，极大地影响患者的生活质量。然而，贲门失弛缓症对包括抑郁症在内的情绪障碍发展的影响在很大程度上仍不明确。本研究的目的是评估贲门失弛缓症患者中抑郁症的发病率。
我们分析了德国一个大型初级保健队列数据库，该数据库收集了749万患者的数据。
在2005年1月至2018年12月期间诊断出的总共n = 1057例贲门失弛缓症患者与n = 3171例无贲门失弛缓症的患者队列进行匹配，匹配因素包括年龄、性别、医生、索引年份和查尔森合并症指数。有趣的是，虽然在贲门失弛缓症诊断之前两组的抑郁症发生率相当，但与对照组相比，贲门失弛缓症诊断后一年内抑郁症的新诊断率显著更高，这表明贲门失弛缓症与抑郁症之间存在直接且此前未被认识到的关联。
我们的数据表明，贲门失弛缓症患者的临床管理应包括对情绪障碍进行仔细且结构化的检查，以改善这些患者的长期生活质量。
