Öster Sara, Spelman Tim, Bensing Sophie, Skov Jakob
Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinskavägen 37A QB85, Stockholm SE-171 76, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm SE-171 76, Sweden.
Eur J Endocrinol. 2025 Jul 31;193(2):262-269. doi: 10.1093/ejendo/lvaf155.
The effect of autoimmune Addison's disease (AAD) on mental health is not well known. The aim of this study was to examine the use of psychotropic drugs around diagnosis and after long-term follow-up in Swedish individuals with AAD.
In this population-based cohort study, national health and population registers and the Swedish Addison Registry were used to identify individuals diagnosed with AAD between July 2006 and December 2019 and matched population controls. The Swedish Prescribed Drug Register was used to retrieve information on annual dispensations (yes/no) of anti-psychotics [Anatomical Therapeutic Chemical (ATC) N05A], anxiolytics (ATC N05B), hypnotics/sedatives (ATC N05C), and anti-depressants (ATC N06A), from 3 years before to 3 years after diagnosis. A cross-sectional analysis of the year 2019 was also performed.
A total of 963 persons with AAD and 9366 matched controls were identified. Use of hypnotics/sedatives, anxiolytics, and anti-depressants was significantly higher in patients with AAD the year preceding diagnosis [ORs 1.72 (1.40-2.11), 1.38 (1.07-1.78), and 1.29 (1.05-1.59), respectively]. After diagnosis, use of hypnotics/sedatives remained significantly higher [ORs 1.42 (1.13-1.78) to 1.78 (1.45-2.19)]. We found no difference in dispensation of other psychotropic drugs after diagnosis. In the cross-sectional analysis of 2019, the increased dispensation of hypnotics/sedatives remained elevated [odds ratio (OR) 1.31 (1.01-1.70)].
Prescription patterns suggest that early symptoms of AAD are associated with or mistaken for mental health disorders. Furthermore, insomnia is common in patients with AAD.
自身免疫性艾迪生病（AAD）对心理健康的影响尚不明确。本研究旨在调查瑞典AAD患者在诊断前后及长期随访后精神药物的使用情况。
在这项基于人群的队列研究中，利用国家健康和人口登记册以及瑞典艾迪生病登记处，识别出2006年7月至2019年12月期间被诊断为AAD的个体以及匹配的人群对照。瑞典处方药登记处用于获取诊断前3年至诊断后3年期间抗精神病药[解剖治疗化学（ATC）分类N05A]、抗焦虑药（ATC N05B）、催眠药/镇静药（ATC N05C）和抗抑郁药（ATC N06A）的年度配药信息（是/否）。还对2019年进行了横断面分析。
共识别出963例AAD患者和9366例匹配对照。在诊断前一年，AAD患者使用催眠药/镇静药、抗焦虑药和抗抑郁药的比例显著更高[比值比（OR）分别为1.72（1.40 - 2.11）、1.38（1.07 - 1.78）和1.29（1.05 - 1.59）]。诊断后，催眠药/镇静药的使用仍显著更高[OR为1.42（1.13 - 1.78）至1.78（1.45 - 2.19）]。我们发现诊断后其他精神药物的配药情况没有差异。在2019年的横断面分析中，催眠药/镇静药的配药增加情况仍然较高[优势比（OR）为1.31（1.01 - 1.70）]。
处方模式表明，AAD的早期症状与心理健康障碍相关或被误诊为心理健康障碍。此外，失眠在AAD患者中很常见。
