Protective Effects of Anti-depressants against the Subsequent Development of Psoriasis in Patients with Major Depressive Disorder: a Cohort Study
Protective Effects of Anti-depressants against the Subsequent Development of Psoriasis in Patients with Major Depressive Disorder: a Cohort Study
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DOI：
10.1016/j.jad.2020.11.110
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发表时间：
2021-01-20
影响因子：
6.6
通讯作者：
Kao, Li-Ting
中科院分区：
文献类型：
--
作者：
Tzeng, Ya-Mei;Li, I-Hsun;Kao, Li-Ting
背景：炎症可能介导重度抑郁障碍（MDD）与牛皮癣之间的关系。然而，目前尚不清楚抗抑郁药是否能降低重度抑郁症患者患牛皮癣的风险。本研究调查了抗抑郁药对MDD患者随后发生牛皮癣风险的影响。方法：本研究是台湾一项以人群为基础的队列研究，纳入58,454名接受抗抑郁药物治疗的MDD患者和6,034名未接受抗抑郁药物治疗的MDD患者。追踪每位患者5年，以确认在索引日期后诊断为牛皮癣。采用Cox比例风险模型估计牛皮癣的风险比（HR）。结果：在本研究中，采用治疗加权逆概率（IPTW）和混杂因素校正的时间相关Cox回归后，抗抑郁药服用者患牛皮癣的风险显著低于未服用者（IPTW校正HR [aHR] = 0.69）。此外，大多数类型和剂量的抗抑郁药倾向于预防牛皮癣。选择性5 -羟色胺再摄取抑制剂（IPTW- ahr = 0.67）和低剂量抗抑郁药（IPTW- ahr = 0.66）即使在IPTW和混杂因素调整后也有显著的保护作用。局限性：本研究没有关于非处方药的信息。结论：本研究揭示了抗抑郁药对重度抑郁症患者牛皮癣风险的保护作用。抗抑郁药使用者患牛皮癣的风险明显低于非使用者。进一步分析表明，使用SSRIs和低剂量抗抑郁药可以统计学上降低牛皮癣的风险。
Background: : Inflammation may mediate the relationship between major depressive disorder (MDD) and psoriasis. However, it is unclear whether anti-depressants can decrease the subsequent risk of psoriasis among MDD patients. This study investigated the effects of anti-depressants on the subsequent risk of psoriasis in MDD patients.Methods: : This was a population-based cohort study in Taiwan. 58,454 MDD patients who had received antidepressants and 6,034 MDD patients who did not receive anti-depressants were included. Each patient was tracked for 5 years to confirm a diagnosis of psoriasis following the index date. Cox proportional hazards models were performed to estimate the hazard ratio (HR) for psoriasis.Results: : In this study, after using time-dependent Cox regression with both inverse probability of treatment weighting (IPTW) and adjustment for confounders, anti-depressant users had a significantly lower risk of psoriasis than the nonusers (IPTW-adjusted HR [aHR] = 0.69). Additionally, most types and dosages of antidepressants tended to protect against psoriasis. Selective serotonin reuptake inhibitor use (IPTW-aHR = 0.67) and low-dose anti-depressant use (IPTW-aHR = 0.66) had significant protective effects even after IPTW and adjustment for confounders.Limitations: : This study had no information about over-the-counter medications.Conclusions: : This study revealed the protective effects of anti-depressants on psoriasis risk in patients with MDD. Antidepressant users had significantly lower risk of psoriasis than the nonusers. Further analyses indicated that the usage of SSRIs and low antidepressant dosage could statistically decrease risk of psoriasis.