Common mental disorders within chronic inflammatory disorders: a primary care database prospective investigation.
OBJECTIVE: There is inconsistent evidence about the association between inflammatory disorders and depression and anxiety onset in a primary care context. The study aimed to evaluate the risk of depression and anxiety within multisystem and organ-specific inflammatory disorders.
METHODS: This is a prospective cohort study with primary care patients from the UK Clinical Practice Research Datalink diagnosed with an inflammatory disorder between 1 January 2001 and 31 December 2016. These patients were matched on age, gender, practice and index date with patients without an inflammatory disorder. The study exposures were seven chronic inflammatory disorders. Clinical diagnosis of depression and anxiety represented the outcome measures of interest.
RESULTS: Among 538 707 participants, the incidence of depression ranged from 14 per 1000 person-years (severe psoriasis) to 9 per 1000 person-years (systemic vasculitis), substantively higher compared with their comparison group (5-7 per 1000 person-years). HRs of multiple depression and anxiety events were 16% higher within inflammatory disorders (HR, 1.16, 95% CI 1.12 to 1.21, p<0.001) compared with the matched comparison group. The incidence of depression and anxiety was strongly associated with the age at inflammatory disorder onset. The overall HR estimate for depression was 1.90 (95% CI 1.66 to 2.17, p<0.001) within early-onset disorder (<40 years of age) and 0.93 (95% CI 0.90 to 1.09, p=0.80) within late-onset disorder (>/=60 years of age).
CONCLUSIONS: Primary care patients with inflammatory disorders have elevated rates of depression and anxiety incidence, particularly those patients with early-onset inflammatory disorders. This finding may reflect the impact of the underlying disease on patients' quality of life, although the precise mechanisms require further investigation.
|ジャーナル名||Annals of the rheumatic diseases|
|投稿者||Dregan, Alexandru; Matcham, Faith; Harber-Aschan, Lisa; Rayner, Lauren; Brailean, Anamaria; Davis, Katrina; Hatch, Stephani; Pariante, Carmine; Armstrong, David; Stewart, Robert; Hotopf, Matthew|
|組織名||Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience,;King's College London, London, UK firstname.lastname@example.org.;King's College London, London, UK.;Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.;School of Population Health & Environmental Sciences, King's College London,;London, UK.;South London and Maudsley NHS Foundation Trust, London, UK.|