Department of Psychosomatic Medicine, Shanghai East Hospital, School of Medicine, Tongji University, 145 Rushan Rd, Shanghai 200120, China; Department of Psychiatry and Behavioral Medicine, Carilion Clinic- Virginia Tech Carilion School of Medicine, 2017 S Jefferson St 2nd Floor, Roanoke 24014, VA, USA.
Northwell Health at Zucker Hillside Hospital, 75-59 263rd St, Glen Oaks 11004, NY, USA.
Gen Hosp Psychiatry. 2024 Sep-Oct;90:30-34. doi: 10.1016/j.genhosppsych.2024.06.009. Epub 2024 Jun 15.
We aimed to use real-world data to characterize the burden of psychiatric comorbidities in young people with eating disorders (EDs) relative to peers without EDs.
This retrospective cohort study used a large federated multi-national network of real-time electronic health records. Our cohort consisted of 124,575 people (14,524 people receiving their index, first-ever, ED diagnosis, compared to 110,051 peers without EDs initiating antidepressants). After 1:1 propensity score matching of the two cohorts by pre-existing demographic and clinical characteristics, we used multivariable logistic regression to compute the adjusted odds ratio (aOR) of psychiatric diagnoses arising in the year following the index event (either first ED diagnosis or first antidepressant script).
Over 50% of people with EDs had prior psychiatric diagnoses in the year preceding the index EDs diagnosis, with mood disorders, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), specific phobia (SP), attention-deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) being the most common. Adjusted analyses showed higher odds for mood disorders (aOR = 1.20 [95% CI = 1.14-1.26]), GAD (aOR = 1.28 [1.21-1.35]), PTSD (aOR = 1.29 [1.18-1.40]), and SP (aOR = 1.45 [1.31-1.60]) in the EDs cohort compared to antidepressant-initiating peers without EDs, although rates of ADHD and ASD were similar in both cohorts.
This large-scale real-time analysis of administrative data illustrates a high burden of co-occurring psychiatric disorders in people with EDs.
本研究旨在利用真实世界数据，描述与非 ED 同龄人相比，青少年饮食障碍（ED）患者合并精神共病的负担。
本回顾性队列研究使用了一个大型的、联邦式的、多国家的实时电子健康记录网络。我们的队列包括 124575 人（14524 人首次确诊 ED，而 110051 人未患 ED 但开始服用抗抑郁药）。在通过预先存在的人口统计学和临床特征对两个队列进行 1:1 倾向评分匹配后，我们使用多变量逻辑回归计算了索引事件（首次 ED 诊断或首次抗抑郁药处方）后一年出现精神诊断的调整比值比（aOR）。
超过 50%的 ED 患者在 ED 诊断前一年就有过先前的精神诊断，其中最常见的是心境障碍、广泛性焦虑障碍（GAD）、创伤后应激障碍（PTSD）、特定恐惧症（SP）、注意缺陷多动障碍（ADHD）和自闭症谱系障碍（ASD）。调整后的分析显示，ED 组出现心境障碍（aOR=1.20 [95%CI=1.14-1.26]）、GAD（aOR=1.28 [1.21-1.35]）、PTSD（aOR=1.29 [1.18-1.40]）和 SP（aOR=1.45 [1.31-1.60]）的几率高于未患 ED 但开始服用抗抑郁药的同龄人，尽管两组的 ADHD 和 ASD 发生率相似。
这项针对行政数据的大规模实时分析表明，ED 患者合并精神共病的负担很重。
