Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea.
J Psychiatr Res. 2024 Oct;178:414-420. doi: 10.1016/j.jpsychires.2024.08.030. Epub 2024 Aug 24.
Depression is frequently reported in amyotrophic lateral sclerosis (ALS) due to the disastrous prognosis of progressive motor impairment, but the risk of depression in ALS is still unclear. Therefore, we investigated the risk of depression in ALS and analyzed the effect of ALS-related physical disability on the risk of developing depression using the Korean National Health Insurance Service (KNHIS) database. A total of 2241 ALS patients, as defined by the International Classification Diseases (ICD, G12.21) and Rare Intractable Disease codes (V123), and 1:10 sex- and age-matched controls were selected from the KNHIS. After applying exclusion criteria (non-participation in national health screening, history of depression, or having missing data), 595 ALS patients and 9896 non-ALS individuals were finally selected. Primary outcome is newly diagnosed depression during follow-up duration defined by ICD code (F32 or F33). A Cox regression model was used to examine the hazard ratios (HRs) after adjustment for potential confounders. During the follow-up period, 283 cases of depression in the ALS group and 1547 in the controls were recorded. The adjusted HR for depression in ALS was 9.1 (95% confidence interval [CI] 7.87-10.60). The risk of depression was slightly higher in the disabled ALS group (aHR 10.1, 95% CI 7.98-12.67) than in the non-disabled ALS group (aHR 8.78, 95% CI 7.42-10.39). The relative risk of depression was higher in younger patients than in older patients, and in obese patients than in non-obese patients. Our study showed that ALS patients have an increased risk of depression compared to non-ALS individuals.
抑郁症在肌萎缩侧索硬化症（ALS）中经常发生，因为进行性运动障碍的预后不佳，但 ALS 患者患抑郁症的风险仍不清楚。因此，我们利用韩国国家健康保险服务（KNHIS）数据库调查了 ALS 患者的抑郁风险，并分析了 ALS 相关身体残疾对发生抑郁风险的影响。根据国际疾病分类（ICD，G12.21）和罕见疑难病编码（V123），从 KNHIS 中选择了 2241 名 ALS 患者（定义为 ALS），并按性别和年龄 1：10 进行了匹配。排除不参加国家健康筛查、有抑郁病史或数据缺失的患者后，最终选择了 595 名 ALS 患者和 9896 名非 ALS 患者。主要结局是通过 ICD 编码（F32 或 F33）定义的随访期间新诊断的抑郁症。使用 Cox 回归模型调整潜在混杂因素后，检查了危险比（HR）。在随访期间，ALS 组有 283 例抑郁症，对照组有 1547 例。ALS 患者抑郁的调整 HR 为 9.1（95%置信区间 [CI] 7.87-10.60）。残疾 ALS 组的抑郁风险略高于非残疾 ALS 组（aHR 10.1，95%CI 7.98-12.67）（aHR 8.78，95%CI 7.42-10.39）。年轻患者的抑郁相对风险高于老年患者，肥胖患者的抑郁相对风险高于非肥胖患者。我们的研究表明，与非 ALS 个体相比，ALS 患者患抑郁症的风险增加。
