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与德国妇科门诊中女性抑郁诊断相关的因素。

Factors associated with the diagnosis of depression in women followed in gynecological practices in Germany.

机构信息

Department of Gynecology and Obstetrics, Philipps University of Marburg, Marburg, Germany.

Epidemiology, IQVIA, Frankfurt, Germany.

出版信息

J Psychiatr Res. 2021 Sep;141:358-363. doi: 10.1016/j.jpsychires.2021.07.018. Epub 2021 Jul 14.

Abstract

BACKGROUND

There are many diagnoses in the field of gynecology that can severely impact the lives of patients and that are associated with an increased risk of developing depression. The goal of this study was to investigate which gynecological diagnoses are associated with depression.

METHODS

This retrospective case-control study based on the Disease Analyzer database (IQVIA) included 5893 women aged 18 years or older with depression and 5893 age-matched pairs followed in 256 gynecological practices in 2019 (index date). A multivariate logistic regression model was used to study the association between 33 pre-defined diagnoses documented within five years prior to the index date and depression diagnosis.

RESULTS

In total, 9 diseases were significantly associated with diagnosis of depression. The strongest association was observed for breast cancer (Odds Ratio (OR: 2.11 (95% Confidence Interval (CI): 1.76-2.52)), followed by female infertility (OR: 1.91 (95% CI: 1.48-2.47)), cancer of female genital organs excl. breast (OR: 1.87 (95% CI: 1.32-2.66)), and sexual dysfunction (OR: 1.63 (95% CI: 1.27-2.09). Other diseases that showed a significant association with depression included endometriosis, mastodynia, candidiasis, infections with a predominantly sexual mode of transmission, and urinary incontinence. Patients with a higher number of different disorders were more likely to be diagnosed with depression (ORs from 1.40 for two disorders to 2.38 for >6 disorders as compared to no disorders).

CONCLUSION

A wide range of diseases documented in gynecologists' practices were associated with depression diagnosis. Understanding all of these associations may help gynecologists to refer women promptly to psychologists or psychiatrists who may help to manage depression in this population.

摘要

背景

妇科领域有许多诊断会严重影响患者的生活,并增加其患抑郁症的风险。本研究旨在探讨哪些妇科诊断与抑郁症有关。

方法

这是一项基于 IQVIA 的疾病分析数据库的回顾性病例对照研究,纳入了 2019 年在 256 家妇科诊所就诊的 5893 名年龄在 18 岁及以上的抑郁症患者(索引日期)和 5893 名年龄匹配的对照组。采用多变量逻辑回归模型,研究了索引日期前五年内记录的 33 种预先定义的诊断与抑郁症诊断之间的关系。

结果

共有 9 种疾病与抑郁症诊断显著相关。关联最强的是乳腺癌(优势比 (OR):2.11(95%置信区间 (CI):1.76-2.52)),其次是女性不孕症(OR:1.91(95% CI:1.48-2.47))、女性生殖器官癌症除外乳腺癌(OR:1.87(95% CI:1.32-2.66))和性功能障碍(OR:1.63(95% CI:1.27-2.09))。其他与抑郁症显著相关的疾病包括子宫内膜异位症、乳房疼痛、念珠菌病、以性传播为主的感染和尿失禁。患有多种不同疾病的患者更有可能被诊断为抑郁症(与无疾病相比,两种疾病的 OR 为 1.40,6 种以上疾病的 OR 为 2.38)。

结论

妇科医生记录的多种疾病与抑郁症诊断有关。了解所有这些关联可能有助于妇科医生及时转介女性给心理学家或精神科医生,以便在该人群中管理抑郁症。

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