Kim Hae Rang, Lee Nang Kyeong, Suh Youngsong, Lee Christopher Seungkyu, Byeon Suk Ho, Kim Sung Soo, Lee Seung Won, Kim Yong Joon
Department of Ophthalmology, Ajou University School of Medicine, Suwon, Republic of Korea.
Department of Computer Science and Engineering, Sungkyunkwan University, Suwon, Republic of Korea.
JAMA Ophthalmol. 2024 Sep 19;142(11):997-1004. doi: 10.1001/jamaophthalmol.2024.3641.
There is a lack of large-scale clinical studies exploring mental health among patients with retinitis pigmentosa (RP). Additionally, few studies have evaluated the associations of visual impairment with mental health in young patients.
To investigate the association between depressive disorder and RP.
DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective, nationwide, population-based cohort study using data obtained from the Health Insurance Review and Assessment service in Korea between 2008 and 2022. A total of 10 879 individuals who were newly diagnosed with RP between January 2011 and December 2021, as verified by both the RP registration code (National Registry of Rare and Intractable Disease in Korea code V209) and diagnostic code (International Statistical Classification of Diseases, 10th Revision code H35.51), were included. Data analysis was performed from October 2023 to January 2024.
Diagnosis of RP.
Participants were categorized into 3 groups based on age at diagnosis (<20, 20-39, and ≥40 years). The incidence of depressive disorder in RP was determined after excluding those diagnosed with depressive disorder prior to RP diagnosis. Age- and sex-adjusted standardized incidence ratios (SIRs) of depressive disorder in patients with RP compared with the general population were calculated. Subgroup analyses by sex and age group were conducted.
A total of 10 879 patients (638 aged <20 years, 2233 aged 20-39 years, and 8008 aged ≥40 years; 5710 [52.5%] female) newly diagnosed with RP between 2011 and 2021 were included. The 10-year cumulative incidence of depressive disorder was 17.67% (95% CI, 16.57%-18.84%) in patients with RP. Subgroup analysis showed higher incidence of depressive disorder in female patients (hazard ratio [HR], 1.46; 95% CI, 1.29-1.65; P < .001) and those aged 40 years or older (HR, 1.93; 95% CI, 1.63-2.29; P < .001). The overall SIR of depressive disorder in patients with RP was 1.19 (95% CI, 1.12-1.27; P < .001), indicating a higher risk of depressive disorder compared with that in the general population. Both male and female patients with RP showed increased incidence rates of depressive disorder (17.53 [95% CI, 15.91-19.27] and 25.57 [95% CI, 23.58-27.67] per 1000 person-years, respectively) and increased SIRs of depressive disorder (1.21 [95% CI, 1.10-1.33] and 1.18 [95% CI, 1.09-1.28], respectively) (all P < .001) compared with the general population. Subgroup analysis by age group showed that the SIR peaked in patients in their 20s (1.50; 95% CI, 1.17-1.90; P = .006) and aged 60 years or older (1.25; 95% CI, 1.14-1.37; P < .001).
Individuals diagnosed with RP had a higher risk of developing depressive disorder. These findings support consideration of providing emotional and social support to patients with RP.
缺乏探索视网膜色素变性（RP）患者心理健康状况的大规模临床研究。此外，很少有研究评估年轻患者视力障碍与心理健康之间的关联。
研究抑郁症与RP之间的关联。
设计、设置和参与者：这是一项基于全国人群的回顾性队列研究，使用了2008年至2022年期间从韩国健康保险审查与评估服务机构获得的数据。共有10879名在2011年1月至2021年12月期间新诊断为RP的个体被纳入，这一诊断通过RP登记代码（韩国罕见和难治性疾病国家登记代码V209）和诊断代码（国际疾病分类第10版代码H35.51）得到验证。数据分析于2023年10月至2024年1月进行。
RP诊断。
参与者根据诊断时的年龄分为3组（<20岁、20 - 39岁和≥40岁）。排除在RP诊断之前被诊断患有抑郁症的个体后，确定RP患者中抑郁症的发病率。计算RP患者与普通人群相比抑郁症的年龄和性别调整标准化发病率（SIR）。进行了按性别和年龄组的亚组分析。
共纳入2011年至2021年期间新诊断为RP的10879名患者（638名年龄<20岁，2233名年龄20 - 39岁，8008名年龄≥40岁；5710名[52.5%]为女性）。RP患者中抑郁症的10年累积发病率为17.67%（95%置信区间，16.57% - 18.84%）。亚组分析显示女性患者（风险比[HR]，1.46；95%置信区间，1.29 - 1.65；P <.001）和40岁及以上患者（HR，1.93；95%置信区间，1.63 - 2.29；P <.001）中抑郁症的发病率更高。RP患者中抑郁症的总体SIR为1.19（95%置信区间，1.12 - 1.27；P <.001），表明与普通人群相比患抑郁症的风险更高。与普通人群相比，RP男性和女性患者抑郁症的发病率（分别为每1000人年17.53[95%置信区间，15.91 - 19.27]和25.57[95%置信区间，23.58 - 27.67]）和SIR（分别为1.21[95%置信区间，1.10 - 1.3...
