Background Rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) are autoimmune disorders associated with an increased risk for depression, anxiety and sleeping problems. The objective of this study was to analyze use of antidepressants and benzodiazepine-related hypnotics (BRH) in Sweden before and after first time treatment with anti-TNF and non-biological systemic (NBS) treatments among patients with the above diagnoses, and to correlate such use with that of randomly selected population controls. Methods Patients and dispensed drugs were identified in nationwide Swedish healthcare registers. Proportions of subjects filling prescriptions of antidepressants and BRH from 2 years before start of treatment (index-date), and 2 years after index date were assessed. Using the period -6 months to index-date as reference, prevalence rate ratios were computed for 6 months' intervals before and after index. For up to ten randomly selected population controls per patient, the same measures were calculated. Results A total of 6256 patients started anti-TNF treatment, and 13,241 NBS treatment. The mean age at index was 52.0 for the anti-TNF group and 56.1 for NBS. Use of antidepressants and BRH was similar in both treatment groups (10.4-12.8%), significantly more common than in the controls (6.6 to 7.6%). For all patients, proportions filling prescriptions for antidepressants and BRH decreased directly or soon after the index; no such changes were seen in the controls, who all showed a slow but steady increase in use over time. Starters of anti-TNF treatment did not show clearer decreases in use of psychotropics than those initiating NBS. Conclusions Decreased rates of dispensed psychotropic drugs after the time of anti-TNF and NBS treatment initiation were seen among patients with autoimmune disorders but not population controls. This may correspond to treatment effects of anti-TNF and NBS also on psychiatric symptoms among these patients.

中文翻译：

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在类风湿性关节炎、银屑病关节炎或强直性脊柱炎患者开始使用 TNF-α 抑制剂或非生物系统治疗之前和之后使用抗抑郁药和苯二氮卓类相关催眠药。

背景 类风湿关节炎 (RA)、银屑病关节炎 (PsA) 和强直性脊柱炎 (AS) 是与抑郁、焦虑和睡眠问题风险增加相关的自身免疫性疾病。本研究的目的是分析瑞典抗抑郁药和苯二氮卓类药物相关催眠药（BRH）在首次接受抗 TNF 和非生物系统（NBS）治疗之前和之后在上述诊断患者中的使用情况，并建立相关性。与随机选择的人口控制一起使用。方法 在瑞典全国医疗保健登记册中确定患者和分配的药物。评估了从治疗开始前 2 年（索引日期）和索引日期后 2 年服用抗抑郁药和 BRH 处方的受试者比例。使用 -6 个月到索引日期作为参考，流行率比率在指数之前和之后以 6 个月的间隔计算。对于每位患者多达十个随机选择的人群对照，计算相同的测量值。结果共有6256例患者开始抗TNF治疗，13241例患者开始NBS治疗。抗 TNF 组的平均指数年龄为 52.0 岁，NBS 组为 56.1 岁。两个治疗组中抗抑郁药和 BRH 的使用相似（10.4-12.8%），明显高于对照组（6.6-7.6%）。对于所有患者，抗抑郁药和BRH处方的比例直接或在指数后不久下降；在对照组中没有看到这样的变化，随着时间的推移，他们都表现出缓慢但稳定的增加。抗 TNF 治疗的起始者在精神药物的使用方面并没有显示出比那些开始 NBS 更明显的减少。结论 在自身免疫性疾病患者中观察到抗 TNF 和 NBS 治疗开始后精神药物配药率降低，但在人群对照中没有观察到。这可能对应于抗 TNF 和 NBS 对这些患者的精神症状的治疗效果。