Minhas Sonica, Chandan Joht Singh, Knibb Rebecca, Diwakar Lavanya, Adderley Nicola
Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
BMJ Open. 2025 May 31;15(5):e089181. doi: 10.1136/bmjopen-2024-089181.
To examine the mental ill health burden associated with allergic and atopic disorders, in a UK primary care cohort.
Population-based retrospective open cohort study.
United Kingdom.
2 491 086 individuals with primary-care recorded atopic disorder (food allergy, drug allergy, anaphylaxis, urticaria, allergic rhino-conjunctivitis) diagnosis were matched by sex, age (± 2 years), and socio-economic deprivation (Townsend quintile score) at index to 3 120 719 unexposed individuals. The mean age of exposed patients at cohort entry was 39.42 years (SD (SD) 23.65) compared with 35.81 years (SD 22.17) for unexposed patients.
The primary outcome was a composite of mental ill health (severe mental illness, anxiety, depression, eating disorders, obsessive-compulsive disorder (OCD), and self-harm), identified using Read codes. Cox regression was used to estimate adjusted hazard ratios with 95% confidence intervals for the composite mental ill health outcome and each of the individual mental health disorders. Covariates adjusted for were age, sex, alcohol use, smoking status, body mass index (BMI), Townsend deprivation quintile score, asthma exposure, and eczema exposure at baseline.
Between first January 1995 to 31st January 2022, a total of 2 491 086 eligible individuals were identified with a primary care recorded diagnosis of atopic disease and were matched to 3 120 719 unexposed individuals. 229 124 exposed individuals developed a mental ill health outcome during the study period (incidence ratio (IR) 144.13 per 10 000 person-years) compared with 203 450 in the unexposed group (IR 117.82 per 10 000 person-years). This translated to an adjusted hazard ratio (aHR) of 1.16 (95% CI 1.15 to 1.17). Notably, the risk of anxiety was greatest, aHR 1.22 (95% CI 1.21 to 1.23). Our findings were robust to a sensitivity analysis, where individuals were also matched for asthma and eczema.
There is an increased risk of mental ill health disorders among patients with diagnosis of an allergic and atopic disorders. There is a need to consider dual delivery of allergy and psychology services to optimise mental well-being among this cohort.
在英国一个初级保健队列中，研究与过敏性和特应性疾病相关的精神健康负担。
基于人群的回顾性开放队列研究。
英国。
2491086名在初级保健中有特应性疾病（食物过敏、药物过敏、过敏反应、荨麻疹、过敏性鼻结膜炎）诊断记录的个体，根据性别、年龄（±2岁）和社会经济剥夺程度（汤森五分位数得分）与3120719名未暴露个体进行匹配。队列进入时，暴露患者的平均年龄为39.42岁（标准差[SD]23.65），未暴露患者为35.81岁（SD 22.17）。
主要结局是使用Read编码确定的精神健康综合指标（严重精神疾病、焦虑、抑郁、饮食失调、强迫症[OCD]和自我伤害）。使用Cox回归估计综合精神健康结局以及每种个体精神健康障碍的调整后风险比和95%置信区间。调整的协变量包括年龄、性别、饮酒情况、吸烟状况、体重指数（BMI）、汤森剥夺五分位数得分、基线时哮喘暴露和湿疹暴露。
在1995年1月1日至2022年1月31日期间，共确定了2491086名有初级保健记录的特应性疾病诊断的合格个体，并与3120719名未暴露个体进行匹配。在研究期间，229124名暴露个体出现了精神健康结局（发病率[IR]为每10000人年144.13），未暴露组为203450名（IR为每10000人年117.82）。这转化为调整后风险比（aHR）为1.16（95%置信区间1.15至1.17）。值得注意的是，焦虑风险最高，aHR为1.22（95%置信区间1.21至1.23）。我们的研究结果在敏感性分析中很稳健，在该分析中个体也根据哮喘和湿疹进行了匹配。
诊断为过敏性和特应性疾病的患者中，精神健康障碍的风险增加。需要考虑同时提供过敏和心理服务，以优化该队列中的心理健康。
