| アブストラクト | The factors that contribute to the development of psoriatic arthritis (PsA) among patients with psoriasis are not well known; however, systemic inflammation is believed to be important. On the basis of recent laboratory work demonstrating that major depressive disorder (MDD) is associated with increased systemic inflammation, we hypothesized that patients with psoriasis who develop MDD are at increased risk of subsequently developing PsA. We utilized The Health Improvement Network, a primary care medical records database, to identify 73,447 individuals with psoriasis. Patients were followed up to 25 years until the development of the primary outcome of PsA or the censor date. The exposure of interest was the development of MDD. Cox proportional-hazards models showed that patients with psoriasis who developed MDD were at significantly increased risk of subsequently developing PsA compared with patients who did not develop MDD, even after accounting for numerous covariates (hazard ratio 1.37, 95% confidence interval 1.05-1.80, P = 0.021). This result was maintained through numerous sensitivity analyses. These data support the hypothesis that MDD increases the risk of developing PsA among patients with psoriasis, suggesting a need for heightened prevention and management of MDD in patients with psoriasis. |
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| 投稿者 | Lewinson, Ryan T; Vallerand, Isabelle A; Lowerison, Mark W; Parsons, Laurie M; Frolkis, Alexandra D; Kaplan, Gilaad G; Bulloch, Andrew G M; Swain, Mark G; Patten, Scott B; Barnabe, Cheryl |
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| 組織名 | Leaders in Medicine Program, Cumming School of Medicine, Calgary, Alberta,;Canada; Biomedical Engineering Program, Schulich School of Engineering, Calgary,;Alberta, Canada.;Canada; Department of Community Health Sciences, Cumming School of Medicine,;Calgary, Alberta, Canada.;Department of Community Health Sciences, Cumming School of Medicine, Calgary,;Division of Dermatology, Cumming School of Medicine, Calgary, Alberta, Canada.;Alberta, Canada; Division of Gastroenterology, Cumming School of Medicine,;Alberta, Canada; Department of Psychiatry, Cumming School of Medicine, Calgary,;Alberta, Canada; Department of Physiology and Pharmacology, Cumming School of;Medicine, Calgary, Alberta, Canada.;Division of Gastroenterology, Cumming School of Medicine, Calgary, Alberta,;Canada.;Alberta, Canada; Division of Rheumatology, Cumming School of Medicine, Calgary,;Alberta, Canada. Electronic address: ccbarnab@ucalgary.ca. |
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