Te-Chun Shen1, Chien-Yu Wang2, Cheng-Li Lin3, Wei-Chih Liao4, Chia-Hung Chen4, Chih-Yen Tu5, Te-Chun Hsia6, Chuen-Ming Shih6, Wu-Huei Hsu6, Chi-Jung Chung7. 1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chu Shang Show Chwan Hospital, Nantou 557, Taiwan; Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, Taichung 404, Taiwan. 2. Division of Infectious Disease, Department of Internal Medicine, Chu Shang Show Chwan Hospital, Nantou 557, Taiwan. 3. Management Office for Health Data, China Medical University Hospital, China Medical University, Taichung 404, Taiwan. 4. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, Taichung 404, Taiwan. 5. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung 404, Taiwan. Electronic address: chesttu@gmail.com. 6. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung 404, Taiwan. 7. Department of Health Risk Management, College of Management, China Medical University, Taichung 404, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan. Electronic address: cjchung@mail.cmu.edu.tw.
Abstract
BACKGROUND: There is some evidence that the prevalence of depression in patients with tuberculosis (TB) is higher than those in the general population. However, the incidence of depression after Mycobacterium tuberculosis infection remains unknown. Our aim was to assess the association between TB and the subsequent risk of depression. METHODS: We conducted a retrospective cohort study using data from the National Health Insurance (NHI) system of Taiwan. The TB cohort included 9020 patients who were newly diagnosed and recruited between 2000 and 2010. Each patient was randomly frequency-matched for age, sex and the year of index date with four people without TB from the general population. The newly diagnosed depression was followed up until the end of 2011. The relative risks of depression were estimated using Cox proportional hazard models after adjusting for age, sex, index year and comorbidities. RESULTS: The overall incidence rate of depression was 1.54-fold higher in the TB cohort as compared with the controlled cohort (8.15 vs. 5.29 per 1000 person-years, 95% confidence interval [CI]=1.45-1.64). Stratified analyses by gender, age group, monthly income and comorbidities revealed that the adjusted hazard ratio (HR) of depression was higher in males as well as individuals older than 65 years with a low monthly income and comorbidities. CONCLUSION: People who have been diagnosed with TB have a significantly higher risk of developing depression compared with those in the general population. We should pay more attention to this group of individuals and ensure that they are offered appropriate support.
BACKGROUND: There is some evidence that the prevalence of depression in patients with tuberculosis (TB) is higher than those in the general population. However, the incidence of depression after Mycobacterium tuberculosis infection remains unknown. Our aim was to assess the association between TB and the subsequent risk of depression. METHODS: We conducted a retrospective cohort study using data from the National Health Insurance (NHI) system of Taiwan. The TB cohort included 9020 patients who were newly diagnosed and recruited between 2000 and 2010. Each patient was randomly frequency-matched for age, sex and the year of index date with four people without TB from the general population. The newly diagnosed depression was followed up until the end of 2011. The relative risks of depression were estimated using Cox proportional hazard models after adjusting for age, sex, index year and comorbidities. RESULTS: The overall incidence rate of depression was 1.54-fold higher in the TB cohort as compared with the controlled cohort (8.15 vs. 5.29 per 1000 person-years, 95% confidence interval [CI]=1.45-1.64). Stratified analyses by gender, age group, monthly income and comorbidities revealed that the adjusted hazard ratio (HR) of depression was higher in males as well as individuals older than 65 years with a low monthly income and comorbidities. CONCLUSION:People who have been diagnosed with TB have a significantly higher risk of developing depression compared with those in the general population. We should pay more attention to this group of individuals and ensure that they are offered appropriate support.