Abstract：
OBJECTIVE: To investigate whether the association between depression and inflammatory joint disease (IJD; rheumatoid arthritis [RA], psoriatic arthritis [PsA], ankylosing spondylitis/spondyloarthropathies [AS], and juvenile idiopathic arthritis [JIA]) is affected by the severity or treatment-resistance of depression.
METHODS: Parallel cohort studies and case-control studies among 600,404 patients with a depressive episode identified in Swedish nationwide administrative registers. Prospective and retrospective risk for IJD in patients with depression was compared to matched population comparators, and the same associations were investigated in severe or treatment-resistant depression. Analyses were adjusted for comorbidities and sociodemographic covariates.
RESULTS: Patients with depression had an increased risk for later IJD compared to population comparators (adjusted hazard ratio (aHR) for any IJD 1.34 [95% CI 1.30-1.39]; for RA 1.27 [1.15-1.41]; PsA 1.45 [1.29-1.63]; AS 1.32 [1.15-1.52]). In case-control studies, patients with depression more frequently had a history of IJD compared to population controls (adjusted odds ratio (aOR) for any IJD 1.43 [1.37-1.50]; RA 1.39 [1.29-1.49]; PsA 1.59 [1.46-1.73]; AS 1.49 [1.36-1.64]; JIA 1.52 [1.35-1.71]). These associations were not significantly different for severe depression or TRD.
CONCLUSIONS: IJD and depression are bidirectionally associated, but this association does not seem to be influenced by the severity or treatment resistance of depression.
METHODS: Parallel cohort studies and case-control studies among 600,404 patients with a depressive episode identified in Swedish nationwide administrative registers. Prospective and retrospective risk for IJD in patients with depression was compared to matched population comparators, and the same associations were investigated in severe or treatment-resistant depression. Analyses were adjusted for comorbidities and sociodemographic covariates.
RESULTS: Patients with depression had an increased risk for later IJD compared to population comparators (adjusted hazard ratio (aHR) for any IJD 1.34 [95% CI 1.30-1.39]; for RA 1.27 [1.15-1.41]; PsA 1.45 [1.29-1.63]; AS 1.32 [1.15-1.52]). In case-control studies, patients with depression more frequently had a history of IJD compared to population controls (adjusted odds ratio (aOR) for any IJD 1.43 [1.37-1.50]; RA 1.39 [1.29-1.49]; PsA 1.59 [1.46-1.73]; AS 1.49 [1.36-1.64]; JIA 1.52 [1.35-1.71]). These associations were not significantly different for severe depression or TRD.
CONCLUSIONS: IJD and depression are bidirectionally associated, but this association does not seem to be influenced by the severity or treatment resistance of depression.
摘要：
目的：研究抑郁症与炎症性关节病（IJD；类风湿性关节炎[RA]，银屑病关节炎[PsA]，强直性脊柱炎/脊柱关节病[AS]，和青少年特发性关节炎[JIA]）受抑郁症的严重程度或治疗抵抗力的影响。
方法：平行队列研究和病例对照研究，在瑞典全国行政登记中确定的600,404名抑郁发作患者中进行。将抑郁症患者的IJD的前瞻性和回顾性风险与匹配的人群比较进行比较，在重度或难治性抑郁症中进行了同样的相关性研究.对合并症和社会人口统计学协变量进行了调整分析。
结果：与人群比较者相比，抑郁症患者晚期IJD的风险增加（任何IJD1.34[95％CI1.30-1.39]的校正风险比（aHR）；RA1.27[1.15-1.41]；PsA1.45[1.29-1.63]；AS1.32[1.15-1.52]）。在病例对照研究中，与人群对照组相比,抑郁症患者有IJD病史的频率更高(IJD的校正比值比(aOR)为1.43[1.37-1.50];RA1.39[1.29-1.49];PsA1.59[1.46-1.73];AS1.49[1.36-1.64];JIA1.52[1.35-1.71]).这些关联对于重度抑郁症或TRD没有显着差异。
结论：IJD和抑郁症是双向相关的，但这种关联似乎不受抑郁症的严重程度或治疗抵抗的影响.
方法：平行队列研究和病例对照研究，在瑞典全国行政登记中确定的600,404名抑郁发作患者中进行。将抑郁症患者的IJD的前瞻性和回顾性风险与匹配的人群比较进行比较，在重度或难治性抑郁症中进行了同样的相关性研究.对合并症和社会人口统计学协变量进行了调整分析。
结果：与人群比较者相比，抑郁症患者晚期IJD的风险增加（任何IJD1.34[95％CI1.30-1.39]的校正风险比（aHR）；RA1.27[1.15-1.41]；PsA1.45[1.29-1.63]；AS1.32[1.15-1.52]）。在病例对照研究中，与人群对照组相比,抑郁症患者有IJD病史的频率更高(IJD的校正比值比(aOR)为1.43[1.37-1.50];RA1.39[1.29-1.49];PsA1.59[1.46-1.73];AS1.49[1.36-1.64];JIA1.52[1.35-1.71]).这些关联对于重度抑郁症或TRD没有显着差异。
结论：IJD和抑郁症是双向相关的，但这种关联似乎不受抑郁症的严重程度或治疗抵抗的影响.
