Incidence and risk factors of mental illnesses among patients with systemic autoimmune rheumatic diseases: an 18-year population-based study

Author:

Chu Wei-Min12345ORCID,Chao Wen-Cheng3678ORCID,Chen Der-Yuan910ORCID,Ho Wei-Li11,Chen Hsin-Hua31213ORCID

Affiliation:

1. Department of Family Medicine, Taichung Veterans General Hospital , Taichung, Taiwan

2. School of Medicine, National Yang Ming Chiao Tung University , Taipei, Taiwan

3. Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University , Taichung, Taiwan

4. Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University , Taichung, Taiwan

5. Department of Epidemiology on Aging, National Center for Geriatrics and Gerontology , Aichi, Japan

6. Department of Critical Care Medicine, Taichung Veterans General Hospital , Taichung, Taiwan

7. Big Data Center, National Chung Hsing University , Taichung, Taiwan

8. Department of Automatic Control Engineering, Feng Chia University , Taichung, Taiwan

9. Deparment of Rheumatology and Immunology, China Medical University Hospital , Taichung, Taiwan

10. College of Medicine, China Medical University , Taichung, Taiwan

11. Division of Allergy, Immunology and Rheumatology, Chiayi Branch, Taichung Veterans General Hospital , Chiayi, Taiwan

12. Division of General Medicine, Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital , Taichung, Taiwan

13. Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine & Big Data Center, Chung Hsing University , Taichung, Taiwan

Abstract

Abstract Objective This study aimed to assess the incidence and risk factors surrounding mental illnesses in patients diagnosed with systemic autoimmune rheumatic diseases (SARDs). Methods This retrospective cohort study used nationwide, population-based claim data taken from Taiwan’s National Health Insurance Research Database (NHIRD) to identify patients certified as having a catastrophic illness for systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), dermatomyositis (DM), polymyositis (PM) or Sjögren’s syndrome (SS) from the years 2002–2020. We furthermore calculated the incidence of mental illness in patients diagnosed with SARDs while exploring factors associated with the development of mental illness using multivariable Cox regression analysis shown as adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Results Among the 28 588 participants, the average age was 47.4 (SD 14.9) years, with most participants being female (76.4%). When compared with patients with rheumatoid arthritis, patients with SLE (HR: 1.20, 95% CI: 1.10–1.32), SS (HR: 1.29, 95% CI: 1.19–1.39), and DM (HR: 1.28, 95% CI: 1.04–1.32) showed a significantly increased risk of developing mental illness. Additionally, when compared with patients with rheumatoid arthritis, patients with SLE (HR: 1.32, 95% CI: 1.21–1.44), SSc (HR: 1.20, 95% CI: 1.02–1.41), SS (HR: 1.17, 95% CI: 1.08–1.26), DM (HR: 1.73, 95% CI: 1.44–2.07), and PM (HR: 1.64, 95% CI: 1.32–2.03) showed a significantly increased risk of antidepressant use. Conclusion This population-based cohort study revealed that patients diagnosed with SLE, SS, and DM had significantly higher risks of developing mental illness when compared with patients with RA.

Funder

Taichung Veterans General Hospital, Taiwan

Publisher

Oxford University Press (OUP)

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