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Kong Y, Yao Z, Ren L, Zhou L, Zhao J, Qian Y, Lou D. Depression and hepatobiliary diseases: a bidirectional Mendelian randomization study. Front Psychiatry 2024; 15:1366509. [PMID: 38596638 PMCID: PMC11002219 DOI: 10.3389/fpsyt.2024.1366509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/11/2024] [Indexed: 04/11/2024] Open
Abstract
Background More and more evidence suggests a close association between depression and hepatobiliary diseases, but its causal relationship is not yet clear. Method Using genome-wide association studies (GWAS) to summarize data, independent genetic variations associated with depression were selected as instrumental variables. Firstly, we designed a univariate Mendelian randomization (UVMR) analysis with two samples and simultaneously conducted reverse validation to evaluate the potential bidirectional causal relationship between depression and various hepatobiliary diseases. Secondly, we conducted a multivariate Mendelian randomization (MVMR) analysis on diseases closely related to depression, exploring the mediating effects of waist to hip ratio, hypertension, and daytime nap. The mediating effects were obtained through MVMR. For UVMR and MVMR, inverse variance weighted method (IVW) is considered the most important analytical method. Sensitivity analysis was conducted using Cochran'Q, MR Egger, and Leave-one-out methods. Results UVMR analysis showed that depression may increase the risk of non-alcoholic fatty liver disease (OR, 1.22; 95% CI, 1.03-1.46; p=0.0248) in liver diseases, while depression does not increase the risk of other liver diseases; In biliary and pancreatic related diseases, depression may increase the risk of cholelithiasis (OR, 1.26; 95% CI, 1.05-1.50; p=0.0120), chronic pancreatitis (OR, 1.61; 95% CI, 1.10-2.35; p=0.0140), and cholecystitis (OR, 1.23; 95% CI, 1.03-1.48; p=0.0250). In addition, through reverse validation, we found that non-alcoholic fatty liver disease, cholelithiasis, chronic pancreatitis, cholecystitis, or the inability to increase the risk of depression (p>0.05). The waist to hip ratio, hypertension, and daytime nap play a certain role in the process of depression leading to non-alcoholic fatty liver disease, with a mediating effect of 35.8%. Conclusion Depression is a susceptibility factor for non-alcoholic fatty liver disease, and the causal effect of genetic susceptibility to depression on non-alcoholic fatty liver disease is mediated by waist-hip ratio, hypertension, and daytime nap.
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Affiliation(s)
- Yu Kong
- Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhongcai Yao
- Zhuji Hospital Affiliated of Wenzhou Medical University, Shaoxing, Zhejiang, China
| | - Lingli Ren
- Zhuji Hospital Affiliated of Wenzhou Medical University, Shaoxing, Zhejiang, China
| | - Liqin Zhou
- Zhuji Hospital Affiliated of Wenzhou Medical University, Shaoxing, Zhejiang, China
| | - Jinkai Zhao
- Zhuji Hospital Affiliated of Wenzhou Medical University, Shaoxing, Zhejiang, China
| | - Yuanyuan Qian
- Basic Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Dayong Lou
- Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhuji Hospital Affiliated of Wenzhou Medical University, Shaoxing, Zhejiang, China
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O'Gara B, Espinosa Leon JP, Robinson K, Schaefer M, Talmor D, Fischer M. New onset postoperative depression after major surgery: an analysis from a national claims database. BJA OPEN 2023; 8:100223. [PMID: 37766788 PMCID: PMC10520326 DOI: 10.1016/j.bjao.2023.100223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/27/2023] [Indexed: 09/29/2023]
Abstract
Background Postoperative depression is not well characterised. We investigated the incidence of postoperative depression with the hypothesis that after controlling for confounders, new onset depression would vary significantly by surgical type. Methods We conducted a retrospective cohort study using the Optum Clinformatics Datamart. The primary outcome was new onset postoperative depression, defined by a new diagnosis of depression or new prescription for an antidepressant in the year after surgery using International Classification of Diseases (ICD) 9/10 codes and drug names. Adjustment for preoperative comorbidities and predictors of depression was with multivariable Cox regression and propensity score matching. Sensitivity analyses defining new onset depression as both a new diagnosis of depression and a new prescription for an antidepressant, or either outcome separately, were conducted. Results Data from 132 390 cardiac surgery, 12 538 thoracotomy, 32 630 video-assisted thoracoscopic surgery (VATS), 96 750 hip fracture surgery, 157 484 hip replacement, and 347 878 laparoscopic cholecystectomy patients from January 2004 to June 2021 were analysed. The incidence of new onset postoperative depression was 18.8% for hip fracture surgery, 16.1% for thoracotomy, 12.6% for cardiac surgery, 12.4% for VATS, 8.6% for laparoscopic cholecystectomy, and 6.8% for hip replacement. After multivariable adjustment, hip fracture surgery patients were most likely to develop new onset postoperative depression (hazard ratio [95% confidence interval]) 1.56 [1.45-1.68]), followed by thoracotomy (1.12 [1.03-1.22]), cardiac surgery (1.09 [1.04-1.12]), VATS (0.95 [0.90-1.00]), and hip replacement (0.55 [0.52-0.57]) compared with patients undergoing laparoscopic cholecystectomy (hazard ratio=1). Results from propensity score matched analyses and sensitivity analyses were similar. Conclusions The risk of postoperative depression differs by surgical type after controlling for preoperative characteristics.
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Affiliation(s)
- Brian O'Gara
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Juan Pablo Espinosa Leon
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kortney Robinson
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Maximilian Schaefer
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Daniel Talmor
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Michael Fischer
- Division of Pharmacoepidemiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Harvard School of Public Health, Boston, MA, USA
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Li J, Zhang J, Kong B, Chen L, Yuan J, He M, Wang Y, Wei S, Chen W, Tang Y, Zhu X, Yao P. Abdominal obesity mediates the causal relationship between depression and the risk of gallstone disease: retrospective cohort study and Mendelian randomization analyses. J Psychosom Res 2023; 174:111474. [PMID: 37689051 DOI: 10.1016/j.jpsychores.2023.111474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/13/2023] [Accepted: 08/22/2023] [Indexed: 09/11/2023]
Abstract
OBJECTIVE Our study aimed to explore the causal effect of depression on the risk of gallstone disease, and the mediation effects of metabolic traits. METHODS A retrospective cohort study on Chinese elderly from the Dongfeng-Tongji cohort (including 18,141 individuals) was conducted to estimate the adverse effect of probable depression on the risk of gallstone disease. Two-sample Mendelian randomization was performed in European and East-Asian ancestries, to verify the causal relationship between major depression and gallstone disease. We further applied two-step Mendelian randomization to explore the mediation effects of metabolic traits. RESULTS In the cohort study, probable depression was associated with an increased risk of gallstone disease within 5 years, with RR (95% CI) of 1.33 (1.12, 1.58) in multivariable regression, and 1.34 (1.11, 1.61) following propensity score weighting. Bidirectional Mendelian randomization in European ancestry revealed a positive causal effect (OR: 1.21; 95% CI: 1.07 to 1.37) of genetically predicted major depression liability on gallstone disease, based on the inverse variance weighted method. Little evidence was presented from other complementary approaches, and the analysis in East-Asian ancestry (IVW estimated OR: 1.03; 95% CI: 0.92 to 1.15). The indirect effect via waist circumference and HDL-C were 1.06 (95% CI: 1.02 to 1.10) and 1.01 (95% CI: 1.00 to 1.01) respectively, which mediated 25.8% and 3.78% of the causal relationship. CONCLUSIONS Our study suggested a higher risk of gallstone disease in the population with probable depression, while the two-sample Mendelian randomization provided weak evidence for the causal relationship, which was moderately mediated by abdominal obesity.
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Affiliation(s)
- Jingxi Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jun Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Bingxuan Kong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Li Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jing Yuan
- Institute of Occupational Medicine and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Meian He
- Institute of Occupational Medicine and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Youjie Wang
- Institute of Occupational Medicine and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Weihong Chen
- Institute of Occupational Medicine and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yuhan Tang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xinhong Zhu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan 430070, China
| | - Ping Yao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Ullah S, Yang BH, Liu D, Lu XY, Liu ZZ, Zhao LX, Zhang JY, Liu BR. Are laparoscopic cholecystectomy and natural orifice transluminal endoscopic surgery gallbladder preserving cholecystolithotomy truly comparable? A propensity matched study. World J Gastrointest Surg 2022; 14:470-481. [PMID: 35734621 PMCID: PMC9160690 DOI: 10.4240/wjgs.v14.i5.470] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/18/2022] [Accepted: 04/09/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cholecystectomy is the preferred treatment option for symptomatic gallstones. However, another option is gallbladder-preserving cholecystolithotomy which preserves the normal physiological functions of the gallbladder in patients desiring to avoid surgical resection. AIM To compare the feasibility, safety and effectiveness of pure natural orifice transluminal endoscopic surgery (NOTES) gallbladder-preserving cholecystolithotomy vs laparoscopic cholecystectomy (LC) for symptomatic gallstones. METHODS We adopted propensity score matching (1:1) to compare trans-rectal NOTES cholecystolithotomy and LC patients with symptomatic gallstones. We reviewed 2511 patients with symptomatic gallstones from December 2017 to December 2020; 517 patients met the matching criteria (NOTES, 110; LC, 407), yielding 86 pairs. RESULTS The technical success rate for the NOTES group was 98.9% vs 100% for the LC group. The median procedure time was 119 min [interquartile ranges (IQRs), 95-175] with NOTES vs 60 min (IQRs, 48-90) with LC (P < 0.001). The frequency of post-operative pain was similar between NOTES and LC: 4.7% (4/85) vs 5.8% (5/95) (P = 0.740). The median duration of post-procedure fasting with NOTES was 1 d (IQRs, 1-2) vs 2 d with LC (IQRs, 1-3) (P < 0.001). The median post-operative hospital stay for NOTES was 4 d (IQRs, 3-6) vs 4 d for LC (IQRs, 3-5), (P = 0.092). During follow-up, diarrhea was significantly less with NOTES (5.8%) compared to LC (18.6%) (P = 0.011). Gallstones and cholecystitis recurrence within a median of 12 mo (range: 6-40 mo) following NOTES was 10.5% and 3.5%, respectively. Concerns regarding the presence of abdominal wall scars were present in 17.4% (n = 15/86) of patients following LC (mainly women). CONCLUSION NOTES provides a feasible new alternative scar-free treatment for patients who are unwilling or unable to undergo cholecystectomy. This minimally invasive organ-sparing procedure both removes the gallstones and preserves the physiological function of the gallbladder. Reducing gallstone recurrence is essential to achieving widespread clinical adoption of NOTES.
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Affiliation(s)
- Saif Ullah
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Bao-Hong Yang
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
- Department of Oncology, Weifang People's Hospital, Weifang 261000, Shandong Province, China
| | - Dan Liu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Xue-Yang Lu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Zhen-Zhen Liu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Li-Xia Zhao
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Ji-Yu Zhang
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Bing-Rong Liu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou 450052, Henan Province, China
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Abstract
Laparoscopic cholecystectomy is now considered the procedure of choice for uncomplicated symptomatic gallstone disease worldwide. Various biliary, vascular, gastrointestinal, neurological and local complications may be seen on imaging post surgery. Knowledge of these entities and imaging appearances is indispensable for the radiologist in today's era. We emphasize on the list of potential complications and imaging appearances of this surgical procedure.
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Affiliation(s)
- Binit Sureka
- Department of Radiology/Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Amar Mukund
- Department of Radiology/Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
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Jin EH, Han K, Lee DH, Shin CM, Lim JH, Yoon H, Kim N. Increased Risk of Major Depressive Disorder After Cholecystectomy: A Nationwide Population-Based Cohort Study in Korea. Clin Transl Gastroenterol 2021; 12:e00339. [PMID: 33929976 PMCID: PMC8059997 DOI: 10.14309/ctg.0000000000000339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/05/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION This study investigated the risk of depression in Korean adults who underwent cholecystectomy and appeared for subsequent long-term follow-ups. A national population-based data set was used for analysis. METHODS All patients (n = 111,934) aged 40 years and older who underwent cholecystectomy between 2010 and 2015 and a control population (n = 223,868), matched for age and sex, were identified from the database of the Korean National Health Insurance Corporation. The hazard ratio (HR) and 95% confidence interval (CI) of depression were estimated after cholecystectomy, and a Cox regression analysis was performed. RESULTS The incidence of depression in the cholecystectomy group was 27.3 per 1,000 person-years and that in the control group was 20.3 per 1,000 person-years. Patients who underwent cholecystectomy showed an increased risk of major depressive disorder (MDD) with an adjusted HR (aHR) of 1.34 (95% CI: 1.31-1.37, P < 0.001). The mean follow-up period after a 1-year lag was 3.67 ± 1.79 years. In the subgroup analysis, the risk of developing MDD after cholecystectomy was relatively high in patients aged 40-49 years (aHR 1.51, 95% CI: 1.44-1.58) and in participants without diabetes mellitus (aHR: 1.36, 95% CI: 1.33-1.39), hypertension (aHR: 1.38, 95% CI: 1.34-1.42), or dyslipidemia (aHR: 1.35, 95% CI: 1.32-1.38). DISCUSSION Compared with the control population, patients who underwent cholecystectomy exhibited an increased incidence of MDD. Thus, physicians should implement an enhanced program of MDD screening for at least several years after cholecystectomy.
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Affiliation(s)
- Eun Hyo Jin
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea;
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Dong Ho Lee
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggido, South Korea.
| | - Cheol Min Shin
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggido, South Korea.
| | - Joo Hyun Lim
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea;
| | - Hyuk Yoon
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggido, South Korea.
| | - Nayoung Kim
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggido, South Korea.
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Boakye M, Sharma M, Adams S, Chandler T, Wang D, Ugiliweneza B, Drazin D. Patterns and Impact of Electronic Health Records-Defined Depression Phenotypes in Spine Surgery. Neurosurgery 2021; 89:E19-E32. [PMID: 33862621 DOI: 10.1093/neuros/nyab096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 01/21/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Preoperative depression is a risk factor for poor outcomes after spine surgery. OBJECTIVE To understand effects of depression on spine surgery outcomes and healthcare resource utilization. METHODS Using IBM's MarketScan Database, we identified 52 480 patients who underwent spinal fusion. Retained patients were classified into 6 depression phenotype groups based on International Classification of Disease, 9th/10th Revision (ICD-9/10) codes and use/nonuse of antidepressant medications: major depressive disorder (MDD), other depression (OthDep), antidepressants for other psychiatric condition (PsychRx), antidepressants for physical (nonpsychiatric) condition (NoPsychRx), psychiatric condition only (PsychOnly), and no depression (NoDep). We analyzed baseline demographics, comorbidities, healthcare utilization/payments, and chronic opioid use. RESULTS Breakdown of groups in our cohort: MDD (15%), OthDep (12%), PsychRx (13%), NonPsychRx (15%), PsychOnly (12%), and NoDep (33%). Postsurgery: increased outpatient resource utilization, admissions, and medication refills at 1, 2, and 5 yr in the NoDep, PsychOnly, NonPsychRx, PsychRx, and OthDep groups, and highest in MDD. Postoperative opioid usage rates remained unchanged in MDD (44%) and OthDep (36%), and reduced in PsychRx (40%), NonPsychRx (31%), and PsychOnly (20%), with greatest reduction in NoDep (13%). Reoperation rates: 1 yr after index procedure, MDD, OthDep, PsychRx, NonPsychRx, and PsychOnly had more reoperations compared to NoDep, and same at 2 and 5 yr. In NoDep patients, 45% developed new depressive phenotype postsurgery. CONCLUSION EHR-defined classification allowed us to study in depth the effects of depression in spine surgery. This increased understanding of the interplay of mental health will help providers identify cohorts at risk for high complication rates, and health care utilization.
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Affiliation(s)
- Maxwell Boakye
- Department of Neurosurgery, University of Louisville, Louisville, Kentucky, USA
| | - Mayur Sharma
- Department of Neurosurgery, University of Louisville, Louisville, Kentucky, USA
| | - Shawn Adams
- Department of Neurosurgery, University of Louisville, Louisville, Kentucky, USA
| | - Thomas Chandler
- Department of Neurosurgery, University of Louisville, Louisville, Kentucky, USA
| | - Dengzhi Wang
- Department of Neurosurgery, University of Louisville, Louisville, Kentucky, USA
| | | | - Doniel Drazin
- Pacific Northwest University of Health Sciences, Yakima, Washington, USA
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Chung SD, Kao LT, Lin HC, Xirasagar S, Huang CC, Lee HC. Patients receiving androgen deprivation therapy for prostate cancer have an increased risk of depressive disorder. PLoS One 2017; 12:e0173266. [PMID: 28253340 PMCID: PMC5333913 DOI: 10.1371/journal.pone.0173266] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 02/07/2017] [Indexed: 11/22/2022] Open
Abstract
Androgen deprivation therapy (ADT) results in testosterone suppression, a hypothesized mechanism linking ADT to depressive symptoms. This study investigated the relationship between ADT and the risk of subsequently being diagnosed with depressive disorder (DD) during a 3-year follow-up period. The patient sample for this population-based, retrospective cohort study was retrieved from the Taiwan Longitudinal Health Insurance Database 2005. We included all 1714 patients aged over 40 years with a first-time diagnosis of prostate cancer (PC) during 2001 to 2010 who did not have an orchiectomy. Among them, we defined 868 patients who received ADT during the 3-year follow-up period as the study group, and 846 patients who did not receive ADT as the comparison group. The incidence rates of DD per 1000 person-years were 13.9 (95% confidence interval (CI): 9.5~19.6) and 6.7 (95% CI: 3.7~11.0), respectively. Cox proportional hazard regressions showed that the adjusted hazard ratio for DD for ADT recipients was 1.93 (95% CI: 1.03~3.62) relative to the comparison group. This study presents epidemiological evidence of an association between ADT and a subsequent DD diagnosis.
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Affiliation(s)
- Shiu-Dong Chung
- Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Banciao, Taipei, Taiwan
- Graduate Program in Biomedical Informatics, College of Informatics, Yuan-Ze University, Chungli, Taiwan
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Li-Ting Kao
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
| | - Herng-Ching Lin
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Sudha Xirasagar
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, United States of America
| | - Chung-Chien Huang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Chien Lee
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Taipei Medical University-Shuang-Ho Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University
- * E-mail:
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Wilson BR, Tringale KR, Hirshman BR, Zhou T, Umlauf A, Taylor WR, Ciacci JD, Carter BS, Chen CC. Depression After Spinal Surgery: A Comparative Analysis of the California Outcomes Database. Mayo Clin Proc 2017; 92:88-97. [PMID: 27836112 PMCID: PMC5426910 DOI: 10.1016/j.mayocp.2016.06.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/11/2016] [Accepted: 06/20/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To examine the relative incidence of newly recorded diagnosis of depression after spinal surgery as a proxy for the risk of post-spinal surgery depression. PATIENTS AND METHODS We used the longitudinal California Office of Statewide Health Planning and Development database (January 1, 2000, through December 31, 2010) to identify patients who underwent spinal surgery during these years. Patients with documented depression before surgery were excluded. Risk of new postoperative depression was determined via the incidence of newly recorded depression on any hospitalization subsequent to surgery. For comparison, this risk was also determined for patients hospitalized during the same time period for coronary artery bypass grafting, hysterectomy, cholecystectomy, chronic obstructive pulmonary disease, congestive heart failure exacerbation, or uncomplicated vaginal delivery. RESULTS Our review identified 1,078,639 patients. Relative to the uncomplicated vaginal delivery cohort, the adjusted hazard ratios (HRs) for newly recorded depression within 5 years after the admission of interest were 5.05 for spinal surgery (95% CI, 4.79-5.33), 2.33 for coronary artery bypass grafting (95% CI, 2.15-2.54), 3.04 for hysterectomy (95% CI, 2.88-3.21), 2.51 for cholecystectomy (95% CI, 2.35-2.69), 2.44 for congestive heart failure exacerbation (95% CI, 2.28-2.61), and 3.04 for chronic obstructive pulmonary disease (95% CI, 2.83-3.26). Among patients who underwent spinal surgery, this risk of postoperative depression was highest for patients who underwent fusion surgery (HR, 1.28; 95% CI, 1.22-1.36) or had undergone multiple spinal operations (HR, 1.22; 95% CI, 1.16-1.29) during the analyzed period. CONCLUSION Patients who undergo spinal surgery have a higher risk for postoperative depression than patients treated for other surgical or medical conditions known to be associated with depression.
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Affiliation(s)
| | | | - Brian R Hirshman
- Department of Neurosurgery, University of California, San Diego, CA
| | - Tianzan Zhou
- Department of Neurosurgery, University of California, San Diego, CA
| | - Anya Umlauf
- Department of Psychiatry, University of California, San Diego, CA
| | - William R Taylor
- Department of Neurosurgery, University of California, San Diego, CA
| | - Joseph D Ciacci
- Department of Neurosurgery, University of California, San Diego, CA
| | - Bob S Carter
- Department of Neurosurgery, University of California, San Diego, CA
| | - Clark C Chen
- Department of Neurosurgery, University of California, San Diego, CA.
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