Huang Mao-Hsuan, Cheng Chih-Ming, Hsu Ju-Wei, Bai Ya-Mei, Su Tung-Ping, Li Cheng-Ta, Tsai Shih-Jen, Chan Yee-Lam E, Chen Mu-Hong
Department of Psychiatry, Taipei Veterans General Hospital, Yuanshan and Suao Branch, Ilan, Taiwan.
Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Psychiatry Clin Neurosci. 2025 Jan;79(1):29-36. doi: 10.1111/pcn.13759. Epub 2024 Nov 1.
Bipolar disorder (BD) and major depression have been associated with an increased risk of developing Parkinson's disease (PD); however, few studies have directly compared the risk of PD development between patients with BD and major depression while considering relevant risk factors and psychotropic medications.
Using the Taiwan National Health Insurance Research Database, 21,186 patients with BD, 21,188 patients with major depression, and 42,374 controls were enrolled between 2001 and 2009, and followed until the end of 2011. Individuals who developed PD during the follow-up period were identified. Cox regression models were used to analyze the hazard ratio (HR) of developing PD, adjusting for demographic factors, comorbidities, and psychotropic medication usage.
Both patients with BD [HR 8.63, 95% confidence interval (CI) 6.35-11.72] and those with major depression (HR 5.68, 95% CI 4.15-7.78) had an elevated risk of subsequent PD compared to the controls. Patients with BD were associated with a 51% increased risk of subsequent PD compared with patients with major depression. Long-term treatment with antiepileptic mood stabilizers was associated with increased PD risk among patients with late-onset BD and high Charlson comorbidity index scores. Lithium was not associated with an increased PD risk.
The study highlights an elevated PD risk in patients with BD and major depression compared to the controls, with BD patients at highest risk. Further research is needed to elucidate the complex interplay between psychotropic medications and neurodegenerative processes in BD, aiming to optimize therapeutic strategies and improve patient outcomes.
双相情感障碍（BD）和重度抑郁症与患帕金森病（PD）风险增加相关；然而，很少有研究在考虑相关风险因素和精神药物的情况下，直接比较BD患者和重度抑郁症患者患PD的风险。
利用台湾全民健康保险研究数据库，2001年至2009年间纳入了21186例BD患者、21188例重度抑郁症患者和42374例对照，并随访至2011年底。确定随访期间发生PD的个体。采用Cox回归模型分析发生PD的风险比（HR），并对人口统计学因素、合并症和精神药物使用情况进行校正。
与对照组相比，BD患者[HR 8.63，95%置信区间（CI）6.35 - 11.72]和重度抑郁症患者（HR 5.68，95%CI 4.15 - 7.78）随后发生PD的风险均升高。与重度抑郁症患者相比，BD患者随后发生PD的风险增加51%。在晚发性BD和高查尔森合并症指数评分的患者中，长期使用抗癫痫心境稳定剂与PD风险增加相关。锂与PD风险增加无关。
该研究强调，与对照组相比，BD患者和重度抑郁症患者发生PD的风险升高，其中BD患者风险最高。需要进一步研究以阐明精神药物与BD神经退行性过程之间的复杂相互作用，旨在优化治疗策略并改善患者预后。
