Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Biostatistics and Computing, Yonsei University Graduate School, Seoul, Korea.
PLoS One. 2023 Aug 17;18(8):e0290271. doi: 10.1371/journal.pone.0290271. eCollection 2023.
It has been reported that the risk of mental health problems such as anxiety or depression increases in patients with nontuberculous mycobacterial (NTM) infection. However, no studies have investigated whether the incidence of NTM infection increases in patients with depression. This study aimed to investigate the incidence of NTM infection in patients with depression and evaluate the association between NTM infection and depression stratified by age and sex.
Data from 2002 to 2013 were collected from patients aged ≥ 20 years in the National Health Insurance Service-National Sample Cohort database. Patients with and without depression aged over 20 years were matched with 1 to 4 by sex, age, and year of diagnosis. The incidence rate was calculated in 100,000 person-years, and a multivariable subdistribution hazard model was used to evaluate the adjusted hazard ratio (aHR) for the development of NTM infection.
We included 37,554 individuals (12,752 men and 24,802 women) and 149,213 controls in the depression and non-depression groups, respectively. The cumulative incidence of NTM infection did not differ significantly between the depression and non-depression groups during the follow-up period (22.2 vs. 24.5 per 100,000 person-years, p = 0.571). The age- and sex-stratified effects on the incidence of NTM infection were not significantly higher in patients with depression than in those without depression. After adjusting for covariates including age, sex, comorbidity, income, and region, the risk of NTM infection did not significantly differ between the depression and non-depression groups (aHR 0.83, 95% confidence interval 0.58-1.17).
The incidence of NTM infections in patients with depression was not significantly higher than that in patients without depression. However, due to the small number of NTM infections, we might have underestimated the differences between the two groups. Further studies are needed to identify factors associated with NTM pulmonary disease in patients with depression.
据报道，非结核分枝杆菌（NTM）感染患者出现焦虑或抑郁等心理健康问题的风险增加。然而，目前尚无研究调查抑郁症患者的 NTM 感染发生率是否增加。本研究旨在调查抑郁症患者的 NTM 感染发生率，并评估按年龄和性别分层的 NTM 感染与抑郁症之间的关联。
从国家健康保险服务-国家样本队列数据库中收集了 2002 年至 2013 年 20 岁及以上患者的数据。将 20 岁以上的有和无抑郁症患者按性别、年龄和诊断年份进行 1:1 至 1:4 匹配。以每 10 万人年为单位计算发病率，并使用多变量亚分布风险模型评估发展为 NTM 感染的调整后的风险比（aHR）。
我们纳入了 37554 名患者（男性 12752 名，女性 24802 名）和 149213 名对照组，分别在抑郁症和非抑郁症组中。在随访期间，NTM 感染的累积发生率在抑郁症和非抑郁症组之间无显著差异（每 100000 人年 22.2 与 24.5，p = 0.571）。按年龄和性别分层后，抑郁症患者的 NTM 感染发生率与非抑郁症患者相比并无显著升高。在调整年龄、性别、合并症、收入和地区等混杂因素后，抑郁症组和非抑郁症组的 NTM 感染风险无显著差异（aHR 0.83，95%置信区间 0.58-1.17）。
抑郁症患者的 NTM 感染发生率并不明显高于非抑郁症患者。然而，由于 NTM 感染的数量较少，我们可能低估了两组之间的差异。需要进一步的研究来确定抑郁症患者与 NTM 肺部疾病相关的因素。
