Wei I-Hua, Huang Chih-Chia
Department of Anatomy, China Medical University, Taichung, Taiwan.
Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan.
Psychiatry Investig. 2022 Jun;19(6):418-426. doi: 10.30773/pi.2022.0010. Epub 2022 Jun 15.
The associations of mental illnesses and hypopituitarism have been reported. But, pituitary disorders are rare. The epidemiological studies have rarely addressed these associations between pituitary disorder and mental illnesses. Until now, no cohort study has been conducted to investigate the association.
We performed a nationwide, retrospective cohort study using the Taiwanese National Health Insurance Program dataset to analyze this relationship. In total, 1,194 patients diagnosed with hypopituitarism between 2000 and 2013 were identified. For the control group, 4,776 individuals without hypopituitarism and psychotic diseases were matched (1:4) according to age, sex, and index date. A Cox proportional hazards model was used to determine the adjusted hazard ratio (aHR).
Patients with hypopituitarism had a significantly higher risk of incident depression and anxiety disorders than those without hypopituitarism. The aHRs of depressive and anxiety disorders were 2.98 and 1.67, respectively, for the hypopituitarism cohort. Furthermore, the risk of both hypopituitarism-associated depressive and anxiety disorders was significantly high in female subjects and subjects aged ≥18 years. A statistically significant increase was not observed in the risk of bipolar disorders, dementia, or schizophrenia in the hypopituitarism group compared with the control group.
Although psychiatric morbidities were uncommon for the hypopituitarism cohort, the risk of developing depressive and anxiety disorders was significantly higher in those with hypopituitarism than in those without hypopituitarism.
已有关于精神疾病与垂体功能减退症之间关联的报道。但是,垂体疾病较为罕见。流行病学研究很少涉及垂体疾病与精神疾病之间的这些关联。到目前为止,尚未进行队列研究来调查这种关联。
我们使用台湾国民健康保险计划数据集进行了一项全国性的回顾性队列研究,以分析这种关系。总共确定了2000年至2013年间诊断为垂体功能减退症的1194例患者。对于对照组,根据年龄、性别和索引日期匹配了4776名无垂体功能减退症和精神疾病的个体(1:4)。使用Cox比例风险模型来确定调整后的风险比(aHR)。
垂体功能减退症患者发生抑郁症和焦虑症的风险明显高于无垂体功能减退症的患者。垂体功能减退症队列中抑郁症和焦虑症的aHR分别为2.98和1.67。此外,女性受试者和年龄≥18岁的受试者中,与垂体功能减退症相关的抑郁症和焦虑症的风险均显著较高。与对照组相比,垂体功能减退症组中双相情感障碍、痴呆或精神分裂症的风险未观察到统计学上的显著增加。
尽管垂体功能减退症队列中精神疾病发病率不常见,但垂体功能减退症患者发生抑郁症和焦虑症的风险明显高于无垂体功能减退症的患者。