目的:比较面部运动障碍患者的心理健康障碍患病率,单凭面瘫,和普通民众。
方法:回顾性队列。
方法:美国各地有82个卫生保健组织。
方法:从2011年到2021年,对TriNetX研究网络进行了查询,以寻找没有联合运动的面瘫患者,面瘫和有记载的联合运动,和控制,年龄相匹配,性别,种族,和种族。病例包括传染性,医源性,或者特发性面神经麻痹.先前存在抑郁或焦虑的患者被排除在外。新诊断的抑郁症两年发病率,焦虑,和心理健康处方进行了比较。
结果:在127,573名面瘫患者中,92.5%(n=117,976)仅有面瘫,和7.5%(n=9597)也有记录的联合运动。与对照组相比,仅面瘫患者新发抑郁症的风险增加(8.9%vs7.3%,P<.001)和焦虑(10.1%vs9.6%,P<.001),精神卫生用药率较高(16.6%vs13.1%,P<.001)。有相关记录的患者,与控件相比,患抑郁症的风险最高(19.8%vs8.6%,P<.001),焦虑(20.5%对10.5%,P<.001),和处方(28.1%对15.8%,P<.001)。27.8%(n=2669)接受化学去神经治疗的患者抑郁发生率较低(8.5%vs23.5%,P<.001),焦虑(9.0%vs23.8%,P<.001),和处方(21.6%和30.0%,P<.001)与未发生综合征的患者相比。
结论:面瘫,尤其是突触运动,与心理健康障碍增加有关。将心理健康筛查和治疗纳入综合方法至关重要。化学去神经与联合运动的精神健康障碍减少有关,突出其治疗潜力。
OBJECTIVE: To compare the prevalence of mental health disorders in individuals with facial
synkinesis, facial paralysis alone, and the general population.
METHODS: Retrospective cohort.
METHODS: Eighty-two health care organizations across the United States.
METHODS: The TriNetX Research Network was queried from 2011 to 2021 for patients with facial paralysis without synkinesis, facial paralysis and documented
synkinesis, and controls, matched for age, sex, race, and ethnicity. Cases included infectious, iatrogenic, or idiopathic facial paralysis. Patients with pre-existing depression or anxiety were excluded. Two-year rates of newly diagnosed depression, anxiety, and mental health prescriptions were compared.
RESULTS: Among 127,573 patients with facial paralysis, 92.5% (n = 117,976) had facial paralysis alone, and 7.5% (n = 9597) also had documented synkinesis. Compared to controls, patients with facial paralysis alone had increased risks of new depression (8.9% vs 7.3%, P < .001) and anxiety (10.1% vs 9.6%, P < .001), with higher mental health medication rates (16.6% vs 13.1%, P < .001). Patients with documented
synkinesis, in comparison to controls, had the highest risks of depression (19.8% vs 8.6%, P < .001), anxiety (20.5% vs 10.5%, P < .001), and prescriptions (28.1% vs 15.8%, P < .001). The 27.8% (n = 2669) of synkinetic patients treated with chemodenervation had lower rates of depression (8.5% vs 23.5%, P < .001), anxiety (9.0% vs 23.8%, P < .001), and prescriptions (21.6% vs 30.0%, P < .001) compared to synkinetic patients who were not.
CONCLUSIONS: Facial paralysis, particularly
synkinesis, is linked to increased mental health disorders. Integrating mental health screening and treatment into a comprehensive approach is crucial. Chemodenervation is associated with decreased mental health disorders in
synkinesis, highlighting its therapeutic potential.