Tzu-Chin Lin1, Charles Tzu-Chi Lee2, Te-Jen Lai3, Chun-Te Lee1, Kang-Yun Lee4, Vincent Chin-Hung Chen5, Robert Stewart6. 1. Department of Psychiatry, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., Taichung 40201, Taiwan; Department of Psychiatry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan. 2. Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan. 3. Department of Psychiatry, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., Taichung 40201, Taiwan; Department of Psychiatry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan. 4. Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 5. Department of Psychiatry, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., Taichung 40201, Taiwan; Department of Psychiatry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan. Electronic address: hjcch@yahoo.com.tw. 6. Institute of Psychiatry, King׳s College London, London, UK.
Abstract
BACKGROUND: The relationship between asthma and bipolar disorder has received little research. We sought to investigate this in a large national sample. Previous studies have found mood changes after prednisone use in asthma patients, and we therefore also investigated this exposure in relation to bipolar disorder. METHODS: Cases were identified from Taiwan׳s National Health Insurance Research Database with a new primary diagnosis of asthma (ICD-9:493) between 2000 and 2007. Case status required the presence of any inpatient diagnosis of asthma and/or at least one year diagnosis of asthma in outpatient service. These 46,558 cases were compared to 46,558 sex-, age-, residence- and insurance premium-matched controls and both groups were followed until the end of 2008 for first diagnosis of bipolar disorder (ICD-9 codes 296.0 to 296.16, 296.4 to 296.81 and 296.89). Competing risk adjusted Cox regression analyses were applied, adjusting for sex, age, residence, insurance premium, prednisone, hyperthyroidism, COPD (chronic obstructive pulmonary disease), Charlson comorbidity index, and hospital admission days for any disorder. RESULTS: Of the 93,116 subjects, 161 were ascertained as having bipolar disorder during a mean (SD) follow-up period of 5.7 (2.2) years. Asthma was an independent risk for bipolar disorder in the fully adjusted model. Higher daily dose of prednisone was a risk factor in asthma cases. LIMITATIONS: The severity of asthma and bipolar disorder, and the route/duration of prednisone treatment were not evaluated. CONCLUSIONS: Asthma was associated with increased risk of bipolar disorder. Higher daily dose of prednisone was associated with a further increased risk.
BACKGROUND: The relationship between asthma and bipolar disorder has received little research. We sought to investigate this in a large national sample. Previous studies have found mood changes after prednisone use in asthmapatients, and we therefore also investigated this exposure in relation to bipolar disorder. METHODS: Cases were identified from Taiwan׳s National Health Insurance Research Database with a new primary diagnosis of asthma (ICD-9:493) between 2000 and 2007. Case status required the presence of any inpatient diagnosis of asthma and/or at least one year diagnosis of asthma in outpatient service. These 46,558 cases were compared to 46,558 sex-, age-, residence- and insurance premium-matched controls and both groups were followed until the end of 2008 for first diagnosis of bipolar disorder (ICD-9 codes 296.0 to 296.16, 296.4 to 296.81 and 296.89). Competing risk adjusted Cox regression analyses were applied, adjusting for sex, age, residence, insurance premium, prednisone, hyperthyroidism, COPD (chronic obstructive pulmonary disease), Charlson comorbidity index, and hospital admission days for any disorder. RESULTS: Of the 93,116 subjects, 161 were ascertained as having bipolar disorder during a mean (SD) follow-up period of 5.7 (2.2) years. Asthma was an independent risk for bipolar disorder in the fully adjusted model. Higher daily dose of prednisone was a risk factor in asthma cases. LIMITATIONS: The severity of asthma and bipolar disorder, and the route/duration of prednisone treatment were not evaluated. CONCLUSIONS:Asthma was associated with increased risk of bipolar disorder. Higher daily dose of prednisone was associated with a further increased risk.
Authors: J F Hayes; G M Khandaker; J Anderson; D Mackay; S Zammit; G Lewis; D J Smith; D P J Osborn Journal: Psychol Med Date: 2016-08-01 Impact factor: 7.723
Authors: Qiong Wu; Christina Dalman; Håkan Karlsson; Glyn Lewis; David P J Osborn; Renee Gardner; Joseph F Hayes Journal: Schizophr Bull Date: 2019-03-07 Impact factor: 9.306