Psychiatric comorbidities in patients with alopecia areata in Taiwan: a case-control study
Psychiatric comorbidities in patients with alopecia areata in Taiwan: a case-control study
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DOI：
10.1111/j.1365-2133.2011.10714.x
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发表时间：
2012-03-01
影响因子：
10.3
通讯作者：
Liu, H-N.
中科院分区：
文献类型：
--
作者：
Chu, S-Y.;Chen, Y-J.;Liu, H-N.
斑秃（AA）可能与应激有关，并已被报道与精神疾病有关。然而，AA和共病精神疾病之间的关系还没有进行全国性的研究，发病年龄的影响已经很少reported.Objectives分析AA和各种精神疾病之间的关联，使用全国性的数据库在Taiwan.Methods数据来自2000年至2009年的台湾国民健康保险研究数据库。结果AA患者有较多的焦虑共病史，较少的精神分裂症共病史。发病年龄的差异揭示了合并症的差异。年龄< 20岁的AA患者患抑郁症的危险性增加[比值比（OR）223; 95%可信区间（CI）1.09-4.54]。在20 - 39岁之间的AA发作中观察到焦虑发生率增加（OR 1.43; CI 1.15-1.77）。年龄在40-59岁的AA患者中观察到强迫症（OR 3.00; CI 1.11-8.12）和焦虑（OR 2.05; CI 1.56-2.68）的最高几率。此外，约50%的精神疾病的发生早于AA。结论AA与多种精神疾病有关。AA的发病年龄是与不同精神疾病共病相关的一个重要因素。除了美容影响，这可能会带来焦虑或抑郁，应激神经内分泌免疫学可能在AA和精神疾病的发病机制中发挥重要作用。
Background Alopecia areata (AA) may be related to stress and has been reported to be associated with psychiatric disorders. Nevertheless, a nationwide study of the relationship between AA and comorbid psychiatric diseases has not been conducted, and the effect of onset age has rarely been reported.Objectives To analyse the associations between AA and various psychiatric disorders using a nationwide database in Taiwan.Methods Data were obtained from the National Health Insurance Research Database of Taiwan from 2000 to 2009. In total, 5117 patients with AA and 20 468 age- and gender-matched controls were enrolled.Results Patients with AA tended to have more coexisting anxiety and less comorbid schizophrenia. Differences in ages of onset revealed differences in comorbidities. An increased risk of depression [odds ratio (OR) 2 23; 95% confidence interval (CI) 1.09-4.54] was found in patients with AA aged < 20 years. An increased rate of anxiety (OR 1.43; CI 1.15-1.77) was observed with AA onset between the ages of 20 and 39 years. The highest odds of obsessive-compulsive disorder (OR 3.00; CI 1.11-8.12) and anxiety (OR 2.05; CI 1.56-2.68) were observed in patients with AA aged 40-59 years. Moreover, about 50% of psychiatric disorders occurred earlier than AA.Conclusions AA is related to various psychiatric disorders. Onset age of AA is an important factor in the association with different comorbid psychiatric diseases. In addition to cosmetic impact, which may bring about anxiety or depression, stress neuroendocrine immunology may play an important role in the pathogenesis of both AA and psychiatric disorders.