NEJM:预测精神疾病患者患其他疾病的风险

科技工作者之家 2020-05-07

来源:科研圈



研究表明,患有精神障碍的人死亡率比正常人高出数倍,但这其中自杀只占部分原因,而更多是由于他们患上其他疾病的风险更高。近来一项最新研究,让研究者们能够为他们绘制出风险图,用于更好地进行健康状态监测,及早规避风险。



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研究者已证实,患精神障碍的人群有更高风险发生其它健康状况。

图片来源:昆士兰大学和奥胡斯大学


来源: 昆士兰大学

翻译:页一

审校/编辑:李光昭


根据最新研究成果,研究者们能够为精神障碍患者们绘制出常见疾病的风险图了,如心肺疾病、糖尿病和癌症。


昆士兰大学(University of Queensland)的一项研究表明,患有精神障碍的人群患上其它疾病的可能性要比正常人高出许多倍,这强调了更全面的医疗护理对于他们的必要性。


约翰·麦格拉思(John McGrath)教授任教于昆士兰大学的昆士兰脑科学研究所(Queensland Brain Institute)和丹麦奥胡斯大学(Aarhus University),他带领了一个国际研究小组进行研究,为了让人们能够更多地关注除自杀以外导致死亡的精神疾病。


麦格拉思教授指出:“我们发现,患有焦虑症的女性患心脏病或中风的风险会增加 50% 。患焦虑症 15 年以上的女性人群中,每三人中就有一人会患上这些疾病。”


“我们还研究了患有物质使用障碍的男性群体(例如酒精相关物质使用障碍),发现他们患肠道或肝脏疾病的风险会增加 400% 。在他们确诊超过 15 年后,五分之一的人会患上肠道或肝脏疾病。”


研究者们开发了一个网站,可以根据个体的性别、精神障碍类型、精神障碍确诊年龄和精神障碍确诊后的年限,探究其患上其它疾病的相对风险和绝对风险。


麦格拉思教授说道,之前有研究发现,精神障碍患者的死亡率更高,其中部分原因是自杀,但主要是由其他的常见疾病所导致。也是这一研究促进了他们的研究项目成立。


麦格拉思教授说:“我们需要为精神障碍患者提供更好的医疗护理,因为如果我们能够及早地治疗这些疾病,就能够减缓精神疾病患者与正常人间的‘死亡率落差’”。


“降低过早死亡率的最佳方式是通过全科医生、心理健康医生和精神障碍患者更紧密地合作,及时监测精神障碍患者的总体健康状况。”


“对于患有精神疾病的人来说,需要格外注意自己的身体健康;监测自身体重、坚持锻炼。去看全科医生时,应该要求医生检查自身的总体健康状况,例如血压和血脂水平,而不仅仅是关注精神问题。”


这项研究发表在《新英格兰医学杂志》(The New England Journal of Medicine)上,该研究涵盖了 1900 年至 2015 年间,出生于丹麦的 590 万人口,研究中囊括了十大类精神障碍和九大类身体疾病。


原文链接:  

https://www.eurekalert.org/pub_releases/2020-04/uoq-mhr042420.php 


论文信息

 【标题】

 Association between Mental Disorders and Subsequent Medical Conditions

【作者】Natalie C. Momen et al.

【时间】30 April 2020

【链接】http://dx.doi.org/10.1056/NEJMoa1915784 

【摘要】

BACKGROUND

Persons with mental disorders are at a higher risk than the general population for the subsequent development of certain medical conditions. 

METHODS

We used a population-based cohort from Danish national registries that included data on more than 5.9 million persons born in Denmark from 1900 through 2015 and followed them from 2000 through 2016, for a total of 83.9 million person-years. We assessed 10 broad types of mental disorders and 9 broad categories of medical conditions (which encompassed 31 specific conditions). We used Cox regression models to calculate overall hazard ratios and time-dependent hazard ratios for pairs of mental disorders and medical conditions, after adjustment for age, sex, calendar time, and previous mental disorders. Absolute risks were estimated with the use of competing-risks survival analyses. 

RESULTS

A total of 698,874 of 5,940,299 persons (11.8%) were identified as having a mental disorder. The median age of the total population was 32.1 years at entry into the cohort and 48.7 years at the time of the last follow-up. Persons with a mental disorder had a higher risk than those without such disorders with respect to 76 of 90 pairs of mental disorders and medical conditions. The median hazard ratio for an association between a mental disorder and a medical condition was 1.37. The lowest hazard ratio was 0.82 for organic mental disorders and the broad category of cancer (95% confidence interval [CI], 0.80 to 0.84), and the highest was 3.62 for eating disorders and urogenital conditions (95% CI, 3.11 to 4.22). Several specific pairs showed a reduced risk (e.g., schizophrenia and musculoskeletal conditions). Risks varied according to the time since the diagnosis of a mental disorder. The absolute risk of a medical condition within 15 years after a mental disorder was diagnosed varied from 0.6% for a urogenital condition among persons with a developmental disorder to 54.1% for a circulatory disorder among those with an organic mental disorder. 

CONCLUSIONS

Most mental disorders were associated with an increased risk of a subsequent medical condition; hazard ratios ranged from 0.82 to 3.62 and varied according to the time since the diagnosis of the mental disorder. (Funded by the Danish National Research Foundation and others; COMO-GMC ClinicalTrials.gov number, NCT03847753. opens in new tab.)



本文来自微信公众号“科研圈”。

来源:keyanquan 科研圈

原文链接:https://mp.weixin.qq.com/s?__biz=MzA5NDkzNjIwMg==&mid=2651692405&idx=3&sn=64a343a16acc59c02b00692151f84b74&chksm=8bbe3090bcc9b9868d2b05ac4328d920e96cf73bc768acc33f4ec991b346c47babd899230196#rd

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