Department of Otolaryngology-Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas.
Department of Information Science Technology, Cullen College of Engineering, University of Houston, Houston, Texas.
JAMA Otolaryngol Head Neck Surg. 2024 Nov 1;150(11):943-951. doi: 10.1001/jamaoto.2024.2705.
Chronic rhinosinusitis (CRS) has been associated with anxiety and depression, but the association of socioeconomic factors and temporality has yet to be fully explored.
To determine the bidirectional risk of anxiety and depression for patients with CRS.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study of the National Institutes of Health All of Us database from January 1, 2008, to December 31, 2018, included 2 cohorts of adult patients with and without CRS. The data were analyzed from July 1, 2023, through April 1, 2024. Patients were classified as having CRS if they had at least 2 diagnoses during the study period. Those with a diagnosis of CRS before the study period were excluded. Patients were propensity score matched (1:5) with patients without CRS for age, sex, race, and annual household income.
The primary outcome was the development of anxiety and depression. Patients with CRS were counted as having the primary outcome if it occurred after the criteria for CRS diagnosis were fulfilled. Multivariate logistic regression and survival analysis were performed to determine the odds ratios (ORs) and hazard ratios (HRs) of anxiety and depression. A secondary survival analysis determined the risk of developing CRS between patients with anxiety and depression and controls.
Among 33 732 patients (23 382 [69.3%] female individuals; 510 [1.5%] Asian, 6002 [17.9%] Black or African American, 576 [1.7%] multiracial, and 26 036 [77.2%] White individuals), there were 28 110 controls and 5622 patients with CRS. Along with higher odds of having anxiety (OR, 4.39; 95% CI, 3.95-4.87) and depression (OR, 2.04; 95% CI, 1.86-2.24), patients with CRS were at an increased risk of developing anxiety (HR, 2.79; 95% CI, 2.47-3.15) and depression (HR, 1.40; 95% CI, 1.27-1.55) compared with controls. Additionally, patients with anxiety (HR, 2.37; 95% CI, 2.18-2.57) and depression (HR, 1.59; 95% CI, 1.46-1.72) were at an increased risk of developing chronic rhinosinusitis compared with controls.
In this population-based cohort study of adults with and without CRS, a bidirectional association between common psychiatric disorders and CRS was observed. Physicians and health care clinicians who treat patients with anxiety, depression, and CRS should be vigilant regarding these risks and screen patients appropriately.
慢性鼻-鼻窦炎（CRS）与焦虑和抑郁有关，但社会经济因素和时间的关联尚未得到充分探讨。
确定 CRS 患者焦虑和抑郁的双向风险。
设计、地点和参与者：这是一项从 2008 年 1 月 1 日至 2018 年 12 月 31 日从美国国立卫生研究院所有美国人数据库中进行的回顾性队列研究，包括 2 个有和没有 CRS 的成年患者队列。数据于 2023 年 7 月 1 日至 2024 年 4 月 1 日进行分析。如果患者在研究期间至少有 2 次诊断，则将其归类为患有 CRS。排除在研究前就患有 CRS 的患者。根据年龄、性别、种族和年家庭收入，对患有 CRS 的患者进行倾向评分匹配（1:5）与无 CRS 的患者匹配。
主要结局是焦虑和抑郁的发生。如果 CRS 的诊断标准得到满足后发生了 CRS，则患有 CRS 的患者被视为发生了主要结局。使用多变量逻辑回归和生存分析来确定焦虑和抑郁的比值比（OR）和风险比（HR）。次要生存分析确定了焦虑和抑郁患者与对照组之间发生 CRS 的风险。
在 33732 名患者（23382 名女性；510 名亚裔、6002 名非裔美国人、576 名多种族和 26036 名白人）中，有 28110 名对照者和 5622 名患有 CRS 的患者。患有 CRS 的患者出现焦虑（OR，4.39；95%CI，3.95-4.87）和抑郁（OR，2.04；95%CI，1.86-2.24）的可能性更高，且患有 CRS 的患者出现焦虑（HR，2.79；95%CI，2.47-3.15）和抑郁（HR，1.40；95%CI，1.27-1.55）的风险高于对照组。此外，患有焦虑（HR，2.37；95%CI，2.18-2.57）和抑郁（HR，1.59；95%CI，1.46-1.72）的患者与对照组相比，发生慢性鼻-鼻窦炎的风险更高。
在这项针对有和无 CRS 的成年人的基于人群的队列研究中，观察到常见精神疾病与 CRS 之间存在双向关联。治疗焦虑、抑郁和 CRS 患者的医生和医疗保健临床医生应该警惕这些风险，并适当对患者进行筛查。
