原發性修格蘭氏症候群病人增加憂鬱症危險：台灣世代研究

Increased risk of depression in patients with primary Sjogren's syndrome: A nationwide cohort study in Taiwan

Objectives: There is limited knowledge about the risk of depression in patients with primary Sjogren'ssyndrome (SS). The present study evaluates the incidence and risk factors of depression in patients withprimary SS by using the Taiwan National Health Insurance Research Database.Methods: The diagnosis of primary SS was made according to the criteria of the American-EuropeanConsensus Group. From 2000 to 2011, we conducted a retrospective nationwide cohort study of 439patients with primary SS and 1756 matched patients who did not have primary SS. The Cox proportionalhazards regression model was used to analyze the risk of depression after adjustment for potentialconfounding factors.Results: During the 12-year study period, 25 patients with primary SS (13.52 per 1000 person-years)and 24 control patients (3.13 per 1000 person-years) were diagnosed with depression. The hazard ratioof depression in the primary SS cohort was 2.29 (95% confidence interval [CI], 1.20-4.38). In stratifyinganalyses, none of common comorbidities were significantly associated with increased risk of depression.Conclusion: Patients with primary SS have a significantly greater risk for depression than age- and sexmatchedcontrols. Further studies are needed to identify risk factors associated with depression in patientswith primary SS. 目的：關於原發性修格蘭氏症候群病人是否會增加憂鬱症危險性的證據有限。本研究運用台灣健保資料庫分析原發性修格蘭氏症候群病人罹患憂鬱症的發生率及危險性。方法：原發性修格蘭氏症候群的診斷依據美國歐洲共識小組會議（AECG）所訂立的標準。從2000到2011年間，我們從資料庫回朔性找到439位原發性修格蘭氏症候群病人並配對出1756位沒有修格蘭氏症候群的人做為對照。在校正潛在干擾因子後分析憂鬱症的危險性。結果：在12年的研究期間內，有25位原發性修格蘭氏症候群病人罹患憂鬱症（每千人年13.52位），對照組則有24位（每千人年3.13位）。原發性修格蘭氏症候群罹患憂鬱症的相對危險比為2.29（95%信賴區間1.20-4.38）。在分層分析中，常見共病症並未增加罹患憂鬱症的危險。結論：原發性修格蘭氏症候群病人跟年齡性別相若的對照組相比具有較高罹患憂鬱症的危險。相關的危險因子則待未來後續研究以進一步釐清。