支气管哮喘与精神障碍类型的双向相关性分析
2022/12/21
摘要
背景：支气管哮喘和精神障碍经常同时发生。对其共病的研究通常集中于与某一精神障碍子集之间的相关性。
目的：本研究旨在评估哮喘与10种广泛类型精神障碍之间的双向相关性。
方法：本研究为一项基于人群的队列研究，包括1955年至2011年出生于丹麦的所有个体（N=5053471），纳入所有哮喘患者中2000至2016年之间合并确诊精神障碍的患者，反之亦然。本研究使用Cox回归模型计算精神障碍-哮喘对的总体和时间依赖性风险比（HR），并进行竞争风险生存分析以估计绝对风险。
结果：在随访过程中，共有376756人确诊为精神障碍，364063人发生哮喘。所有双向精神障碍-哮喘对的风险都有所增加。确诊哮喘后，不同后续精神障碍的校正风险比从器质性障碍的1.75（95%CI 1.64，1.87）到人格障碍的2.75（95%CI 2.69，2.81）。确诊精神障碍后，哮喘的风险比从发育障碍的1.06（95%CI 1.00，1.12）到物质使用障碍的2.33（95%CI 2.28，2.39）。自先前的疾病诊断以来，风险随时间而变化，但维持上升趋势。（i）精神障碍后的哮喘和（ii）哮喘后的精神障碍的累积发病率在既往有精神障碍的患者中高于对照组。
结论：本研究结果提供了哮喘与各种精神障碍类型之间双向相关的证据，提示可能存在共同病因或病理生理过程。
Bidirectional associations between asthma and types of mental disorders.
Liu X, Plana-Ripoll O, McGrath JJ, Petersen LV, Dharmage SC, Momen NC.
Abstract
BACKGROUND:Asthma and mental disorders frequently co-occur. Studies of their comorbidity have generally focused on associations related to a subset of mental disorders.
OBJECTIVES: To estimate bidirectional associations between asthma and 10 broad types of mental disorders.
METHODS:In a population-based cohort study, including all individuals born in Denmark between 1955 and 2011 (N=5,053,471), we considered diagnoses of comorbid mental disorders among those with asthma, and vice versa, between 2000 and 2016. We used Cox regression models to calculate overall and time-dependent hazard ratios (HRs) for mental disorder-asthma pairs and competing-risks survival analyses to estimate absolute risks.
RESULTS:Altogether, 376,756 individuals were identified as having an incident mental disorder and 364,063 incident asthma during follow-up. An increased risk was seen for all bidirectional mental disorder-asthma pairs. Following an asthma diagnosis, adjusted HRs for different subsequent mental disorders ranged from 1.75 (95% CI 1.64, 1.87) for organic disorders to 2.75 (95% CI 2.69, 2.81) for personality disorders. Following a prior mental disorder diagnosis, HRs for asthma ranged from 1.06 (95% CI 1.00, 1.12) for developmental disorders to 2.33 (95% CI 2.28, 2.39) for substance use disorders. Risks varied with time since prior disorder diagnosis but remained elevated. Cumulative incidence of (i) asthma after a mental disorder and (ii) a mental disorder after asthma was higher in those with prior disorders than in matched reference groups.
CONCLUSIONS:Our findings provide evidence of bidirectional associations between asthma and each of the mental disorder types, suggesting possible shared etiological factors or pathophysiologic processes.
背景：支气管哮喘和精神障碍经常同时发生。对其共病的研究通常集中于与某一精神障碍子集之间的相关性。
目的：本研究旨在评估哮喘与10种广泛类型精神障碍之间的双向相关性。
方法：本研究为一项基于人群的队列研究，包括1955年至2011年出生于丹麦的所有个体（N=5053471），纳入所有哮喘患者中2000至2016年之间合并确诊精神障碍的患者，反之亦然。本研究使用Cox回归模型计算精神障碍-哮喘对的总体和时间依赖性风险比（HR），并进行竞争风险生存分析以估计绝对风险。
结果：在随访过程中，共有376756人确诊为精神障碍，364063人发生哮喘。所有双向精神障碍-哮喘对的风险都有所增加。确诊哮喘后，不同后续精神障碍的校正风险比从器质性障碍的1.75（95%CI 1.64，1.87）到人格障碍的2.75（95%CI 2.69，2.81）。确诊精神障碍后，哮喘的风险比从发育障碍的1.06（95%CI 1.00，1.12）到物质使用障碍的2.33（95%CI 2.28，2.39）。自先前的疾病诊断以来，风险随时间而变化，但维持上升趋势。（i）精神障碍后的哮喘和（ii）哮喘后的精神障碍的累积发病率在既往有精神障碍的患者中高于对照组。
结论：本研究结果提供了哮喘与各种精神障碍类型之间双向相关的证据，提示可能存在共同病因或病理生理过程。
(中日友好医院呼吸与危重症医学科 张婧媛 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2022 Dec 5:S2213-2198(22)01247-8. doi: 10.1016/j.jaip.2022.11.027.)
(J Allergy Clin Immunol Pract. 2022 Dec 5:S2213-2198(22)01247-8. doi: 10.1016/j.jaip.2022.11.027.)
Bidirectional associations between asthma and types of mental disorders.
Liu X, Plana-Ripoll O, McGrath JJ, Petersen LV, Dharmage SC, Momen NC.
Abstract
BACKGROUND:Asthma and mental disorders frequently co-occur. Studies of their comorbidity have generally focused on associations related to a subset of mental disorders.
OBJECTIVES: To estimate bidirectional associations between asthma and 10 broad types of mental disorders.
METHODS:In a population-based cohort study, including all individuals born in Denmark between 1955 and 2011 (N=5,053,471), we considered diagnoses of comorbid mental disorders among those with asthma, and vice versa, between 2000 and 2016. We used Cox regression models to calculate overall and time-dependent hazard ratios (HRs) for mental disorder-asthma pairs and competing-risks survival analyses to estimate absolute risks.
RESULTS:Altogether, 376,756 individuals were identified as having an incident mental disorder and 364,063 incident asthma during follow-up. An increased risk was seen for all bidirectional mental disorder-asthma pairs. Following an asthma diagnosis, adjusted HRs for different subsequent mental disorders ranged from 1.75 (95% CI 1.64, 1.87) for organic disorders to 2.75 (95% CI 2.69, 2.81) for personality disorders. Following a prior mental disorder diagnosis, HRs for asthma ranged from 1.06 (95% CI 1.00, 1.12) for developmental disorders to 2.33 (95% CI 2.28, 2.39) for substance use disorders. Risks varied with time since prior disorder diagnosis but remained elevated. Cumulative incidence of (i) asthma after a mental disorder and (ii) a mental disorder after asthma was higher in those with prior disorders than in matched reference groups.
CONCLUSIONS:Our findings provide evidence of bidirectional associations between asthma and each of the mental disorder types, suggesting possible shared etiological factors or pathophysiologic processes.
(未知)
上一篇：
上呼吸道病毒是否导致哮喘急诊就诊中的种族和种族差异？
下一篇：
极端温度引发的哮喘：从流行病学证据到生物学合理性
