Kai-Liang Kao1, Fung-Chang Sung2,3,4, Hui-Chun Huang5,6, Chen-Ju Lin7, Shu-Chin Chen8, Cheng-Li Lin2,9, Yo-Ping Huang10, Shu-I Wu5,7,11, Yi-Shin Chen12, Robert Stewart13,14. 1. Department of Pediatrics, Far Eastern Memorial Hospital, Taipei, Taiwan. 2. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 3. Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan. 4. Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan. 5. Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan. 6. MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan. 7. Section of Psychiatry and Suicide Prevention Center, Mackay Memorial Hospital, Taipei, Taiwan. 8. Suicide Prevention Center, Mackay Memorial Hospital, Taipei, Taiwan. 9. College of Medicine, China Medical University, Taichung, Taiwan. 10. Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan. 11. Department of Medicine, Mackay Medical College, Taipei, Taiwan. 12. Department of Computer Science, National Tsing Hua University, Hsinchu, Taiwan. 13. Service and Population Research Department, King's College, Institute of Psychiatry, Psychology & Neuroscience, London, UK. 14. South London and Maudsley NHS Foundation Trust, London, UK.
Abstract
BACKGROUND: Patients with functional dyspepsia (FD) are more likely to have persistent depression, yet whether depression and antidepressant treatments are associated with subsequent risk of FD remain unclear. METHODS: Using population-based insurance administrative data of Taiwan, an 11-year historic cohort study was assembled, comparing cases aged 18 and above with the diagnosis of depressive disorder, to a propensity score-matched sample of adults without depression. Incident FD as a primary diagnosis was ascertained. Hazard ratios of FD were calculated using Cox regression models by age, gender, other comorbidities, nonsteroidal anti-inflammatory medications, antidepressants and antidiabetic agents. RESULTS: A total of 20,197 people with depressive disorder and 20,197 propensity score-matched comparisons without depression were followed up. The incidence of FD was 1.7-fold greater in the depressive cohort than in comparisons (12.9 versus 7.57 per 1000 person-years), with an adjusted hazard ratio (aHR) of 2.16 (95% confidence interval (CI) 1.93~2.41). Increased risks were significant regardless of comorbidities or medication uses, the highest in the untreated depression group compared to the group without depression, with an aHR of 2.51(95% CI 2.15~2.93). CONCLUSIONS: This population-based study showed that patients with depressive disorder are at elevated risk of FD. Antidepressant treatment could reduce the risk of FD.
BACKGROUND: Patients with functional dyspepsia (FD) are more likely to have persistent depression, yet whether depression and antidepressant treatments are associated with subsequent risk of FD remain unclear. METHODS: Using population-based insurance administrative data of Taiwan, an 11-year historic cohort study was assembled, comparing cases aged 18 and above with the diagnosis of depressive disorder, to a propensity score-matched sample of adults without depression. Incident FD as a primary diagnosis was ascertained. Hazard ratios of FD were calculated using Cox regression models by age, gender, other comorbidities, nonsteroidal anti-inflammatory medications, antidepressants and antidiabetic agents. RESULTS: A total of 20,197 people with depressive disorder and 20,197 propensity score-matched comparisons without depression were followed up. The incidence of FD was 1.7-fold greater in the depressive cohort than in comparisons (12.9 versus 7.57 per 1000 person-years), with an adjusted hazard ratio (aHR) of 2.16 (95% confidence interval (CI) 1.93~2.41). Increased risks were significant regardless of comorbidities or medication uses, the highest in the untreated depression group compared to the group without depression, with an aHR of 2.51(95% CI 2.15~2.93). CONCLUSIONS: This population-based study showed that patients with depressive disorder are at elevated risk of FD. Antidepressant treatment could reduce the risk of FD.