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Association between Mental Disorders and Subsequent Medical Conditions.
The New England Journal of Medicine ( IF 96.2 ) Pub Date : 2020-04-30 , DOI: 10.1056/nejmoa1915784
Natalie C Momen 1 , Oleguer Plana-Ripoll 1 , Esben Agerbo 1 , Michael E Benros 1 , Anders D Børglum 1 , Maria K Christensen 1 , Søren Dalsgaard 1 , Louisa Degenhardt 1 , Peter de Jonge 1 , Jean-Christophe P G Debost 1 , Morten Fenger-Grøn 1 , Jane M Gunn 1 , Kim M Iburg 1 , Lars V Kessing 1 , Ronald C Kessler 1 , Thomas M Laursen 1 , Carmen C W Lim 1 , Ole Mors 1 , Preben B Mortensen 1 , Katherine L Musliner 1 , Merete Nordentoft 1 , Carsten B Pedersen 1 , Liselotte V Petersen 1 , Anette R Ribe 1 , Annelieke M Roest 1 , Sukanta Saha 1 , Andrew J Schork 1 , Kate M Scott 1 , Carson Sievert 1 , Holger J Sørensen 1 , Terry J Stedman 1 , Mogens Vestergaard 1 , Bjarni Vilhjalmsson 1 , Thomas Werge 1 , Nanna Weye 1 , Harvey A Whiteford 1 , Anders Prior 1 , John J McGrath 1
Affiliation  

BACKGROUND Persons with mental disorders are at a higher risk than the general population for the subsequent development of certain medical conditions. METHODS We used a population-based cohort from Danish national registries that included data on more than 5.9 million persons born in Denmark from 1900 through 2015 and followed them from 2000 through 2016, for a total of 83.9 million person-years. We assessed 10 broad types of mental disorders and 9 broad categories of medical conditions (which encompassed 31 specific conditions). We used Cox regression models to calculate overall hazard ratios and time-dependent hazard ratios for pairs of mental disorders and medical conditions, after adjustment for age, sex, calendar time, and previous mental disorders. Absolute risks were estimated with the use of competing-risks survival analyses. RESULTS A total of 698,874 of 5,940,299 persons (11.8%) were identified as having a mental disorder. The median age of the total population was 32.1 years at entry into the cohort and 48.7 years at the time of the last follow-up. Persons with a mental disorder had a higher risk than those without such disorders with respect to 76 of 90 pairs of mental disorders and medical conditions. The median hazard ratio for an association between a mental disorder and a medical condition was 1.37. The lowest hazard ratio was 0.82 for organic mental disorders and the broad category of cancer (95% confidence interval [CI], 0.80 to 0.84), and the highest was 3.62 for eating disorders and urogenital conditions (95% CI, 3.11 to 4.22). Several specific pairs showed a reduced risk (e.g., schizophrenia and musculoskeletal conditions). Risks varied according to the time since the diagnosis of a mental disorder. The absolute risk of a medical condition within 15 years after a mental disorder was diagnosed varied from 0.6% for a urogenital condition among persons with a developmental disorder to 54.1% for a circulatory disorder among those with an organic mental disorder. CONCLUSIONS Most mental disorders were associated with an increased risk of a subsequent medical condition; hazard ratios ranged from 0.82 to 3.62 and varied according to the time since the diagnosis of the mental disorder. (Funded by the Danish National Research Foundation and others; COMO-GMC ClinicalTrials.gov number, NCT03847753.).

中文翻译:

精神障碍与随后的医疗状况之间的关联。

背景技术患有精神疾病的人比某些普通人群更高的罹患某些疾病的风险。方法我们使用了来自丹麦国家注册中心的人口队列,其中包括1900年至2015年在丹麦出生的590万人的数据,以及2000年至2016年在丹麦出生的人口的数据,总计8390万人年。我们评估了10种类型的精神障碍和9种类型的医学疾病(包括31种特定疾病)。在调整了年龄,性别,日历时间和以前的精神障碍之后,我们使用Cox回归模型计算了成对的精神障碍和医疗状况的总体危险比和与时间有关的危险比。使用竞争风险生存分析估计绝对风险。结果共有5,940,299人中的698,874人(11.8%)被确定为患有精神障碍。进入队列的总人口中位年龄为32.1岁,上次随访时为48.7岁。就90对精神疾病和医疗状况中的76对而言,精神疾病患者比没有精神疾病的人具有更高的风险。精神障碍与医学状况之间的关联的平均风险比为1.37。器质性精神障碍和广泛的癌症类别的最低危险比为0.82(95%置信区间[CI],0.80至0.84),进食障碍和泌尿生殖系统疾病的最高危险比为3.62(95%CI,3.11至4.22) 。几个特定的​​配对显示出降低的风险(例如,精神分裂症和肌肉骨骼疾病)。风险自诊断为精神障碍以来的时间而异。在诊断出精神障碍后的15年内,发生医疗疾病的绝对风险从发育性疾病患者的泌尿生殖系统疾病的0.6%到循环性精神疾病患者的54.1%的循环系统疾病不等。结论大多数精神障碍与随后患病的风险增加有关。危险比范围从0.82到3.62,并且自诊断出精神障碍以来的时间有所不同。(由丹麦国家研究基金会和其他机构资助; COMO-GMC ClinicalTrials.gov编号,NCT03847753。)。在患有发育性疾病的人中,泌尿生殖系统疾病的患病率为6%,在循环系统疾病中的疾病为54.1%。结论大多数精神障碍与随后患病的风险增加有关。危险比范围从0.82到3.62,并且根据自精神障碍诊断以来的时间而有所不同。(由丹麦国家研究基金会和其他机构资助; COMO-GMC ClinicalTrials.gov编号,NCT03847753。)。在患有发育性疾病的人中,泌尿生殖系统疾病的患病率为6%,在循环系统疾病中的疾病为54.1%。结论大多数精神障碍与随后患病的风险增加有关。危险比范围从0.82到3.62,并且自诊断出精神障碍以来的时间有所不同。(由丹麦国家研究基金会和其他机构资助; COMO-GMC ClinicalTrials.gov编号,NCT03847753。)。
更新日期:2020-04-30
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