■要检查第一次抑郁,焦虑,发生心力衰竭(HF)后一年内的应激障碍或精神药物处方。
■全国流行病学登记研究。
■国家患者登记处。
■2005-2015年丹麦首次诊断为HF的患者。
■无。
■抑郁症的发生率,焦虑,确定了应激障碍或精神药物的首次处方。
■共纳入94,712名HF患者和473,560名匹配的对照(中位年龄74.0[64.0-81.0]岁,60.8%男性)。HF事件发生一年后,11.9%达到主要复合终点(抑郁症,焦虑,或应激障碍或相关精神药物的处方),8.6%的门诊病人和13.3%的住院病人,而对照组的2.4%。开始精神药物治疗占大多数复合终点事件,11.6%的HF患者开始服用抗抑郁药,抗焦虑药,催眠药,或镇静药物(对照组中为2.4%),而0.6%的人接受了抑郁症的注册诊断,焦虑,或应激障碍(对照组中<0.1%)。HF患者与对照组的精神药物处方的相对风险(标准化为年龄,性别,和所有纳入受试者的选定合并症分布)为3.85[95%CI3.73-3.98]。其中一项精神病诊断的相应相对风险为12.90[95%CI10.60-15.19]。
■新诊断的心力衰竭患者中有很大一部分开始使用精神药物治疗,而只有一小部分患有抑郁症,焦虑,或一年随访内的应激障碍。发病率明显高于背景人群。
UNASSIGNED: To examine first-time depression, anxiety, stress disorders or psychotropic drug prescriptions within one year after incident heart failure (HF).
UNASSIGNED: Nationwide Epidemiological registry study.
UNASSIGNED: National patient registries.
UNASSIGNED: Patients in Denmark with a first-time HF diagnosis during 2005–2015.
UNASSIGNED: None.
UNASSIGNED: Incidences of depression, anxiety, stress disorders or first-time prescription of a psychotropic drug were determined.
UNASSIGNED: A total of 94,712 HF patients and 473,560 matched controls were included (median age 74.0 [64.0–81.0] years, 60.8 % males). At one year after incident HF, 11.9 % met the primary composite endpoint (depression, anxiety, or stress disorders or prescription of related psychotropic drugs), with 8.6 % outpatients and 13.3 % in-patients, versus 2.4 % of the controls. Starting psychotropic medication accounted for most of the composite endpoint events, as 11.6 % of the HF patients started antidepressants, anxiolytics, hypnotics, or sedative drugs (2.4 % among controls), while 0.6 % received a registered diagnosis of depression, anxiety, or stress disorder (<0.1 % among controls). The relative risk of psychotropic drug prescriptions in HF patients versus controls (standardized to the age, sex, and selected comorbidity distributions of all included subjects) was 3.85 [95 % CI 3.73–3.98]. The corresponding relative risk for one of the psychiatric diagnoses was 12.90 [95 % CI 10.60–15.19].
UNASSIGNED: A substantial part of patients with newly diagnose heart failure started treatment with psychotropic drugs whereas only a small fraction was registered with depression, anxiety, or stress disorders within one-year follow-up. The incidences were significantly higher than in the background population.