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[大学生论坛]:脑瘫患者抑郁和焦虑的风险

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clt 发表于 2019-1-4 11:59:31 | 显示全部楼层 |阅读模式


JAMA Neurol. 2018 Dec 28. doi: 10.1001/jamaneurol.2018.4147. [Epub ahead of print]
Risk of Depression and Anxiety in Adults With Cerebral Palsy.脑瘫患者抑郁和焦虑的风险
[url=https://www.ncbi.nlm.nih.gov/pubmed/?term=Smith%20KJ[Author]&cauthor=true&cauthor_uid=30592485]Smith KJ[/url]1,2, [url=https://www.ncbi.nlm.nih.gov/pubmed/?term=Peterson%20MD[Author]&cauthor=true&cauthor_uid=30592485]Peterson MD[/url]3, O'Connell NE4, [url=https://www.ncbi.nlm.nih.gov/pubmed/?term=Victor%20C[Author]&cauthor=true&cauthor_uid=30592485]Victor C[/url]2,4, [url=https://www.ncbi.nlm.nih.gov/pubmed/?term=Liverani%20S[Author]&cauthor=true&cauthor_uid=30592485]Liverani S[/url]5, [url=https://www.ncbi.nlm.nih.gov/pubmed/?term=Anokye%20N[Author]&cauthor=true&cauthor_uid=30592485]Anokye N[/url]4, [url=https://www.ncbi.nlm.nih.gov/pubmed/?term=Ryan%20JM[Author]&cauthor=true&cauthor_uid=30592485]Ryan JM[/url]2,6.
Author informationAbstractImportance:
Cerebral palsy (CP) is considered a pediatric condition despite most individuals with CP living into adulthood. Thus, there is a lack of evidence in adults with CP, which includes a paucity of research examining mental health in this population.
重要性:
脑瘫(CP)被认为是一种儿科疾病,尽管大多数脑瘫患者都可以活到成年。因此,针对患有慢性阻塞性脑瘫的成年人心理健康状况的研究证据是相对缺乏的。
Objectives:
To determine the risk of depression and anxiety in adults with CP compared with an age-, sex-, and practice-matched reference group of adults without CP, using primary care data.
目标:
使用初级护理数据,与年龄、性别和实践匹配的参考组无脑瘫的成年人进行比较,以确定患有脑瘫的成年人患抑郁症和焦虑症的风险。
Design, Setting, and Participants:
Retrospective longitudinal cohort study set in UK primary care. Data were analyzed using Cox proportional hazards regression analyses adjusted for chronic conditions and visits to their physician. The study period ran from January 1987 to November 2015. Data of entry into the study ranged from January 1987 to September 2015. Data for 1705 adults 18 years or older with CP and 5115 matched adults without CP were extracted. Cerebral palsy was identified using diagnostic codes, and each person with CP was compared with 3 age-, sex-, and practice-matched controls.
设计、背景和参与者:
在英国初级护理中心进行回顾性纵向队列研究。使用Cox比例危险回归分析,对数据进行了分析,对其进行了长期的调节,并对其医生进行了访问。研究时间为1987年1月至2015年11月。参与研究的数据范围从1987年1月到2015年9月。抽取18岁及18岁以上患者1705例,对照组5115例。使用诊断代码识别脑瘫,并将每位CP患者与3名年龄、性别和实践匹配的对照组进行比较。
Exposures:
Diagnosis of CP, with a second analysis accounting for comorbidity of intellectual disability (ID).
揭露:
诊断为CP,其次分析了智力障碍(ID)共病的原因。
Main Outcomes and Measures:
Time to diagnosis for depression or anxiety following the date of entry into the study in adults with CP (with and without ID) compared with matched controls.
主要成果和措施:
与对照组相比,患有CP(有或无ID)的成人在进入研究后的抑郁或焦虑的诊断时间。
Results:
The mean (SD) age of the 1705 patients with CP and the 5115 adults without CP was 33.3 (15.5) years, and 798 participants (46.8%) were women. Individuals with CP had an increased adjusted hazard of depression (hazard ratio [HR], 1.28; 95% CI, 1.09-1.51) and anxiety (HR, 1.40; 95% CI, 1.21-1.63) compared with the matched reference group. When we accounted for ID comorbidity, there were 363 adults with CP who also had ID (mean [SD] age, 32.1 [13.2] years; 159 women [47.6%]) and 1342 adults with CP who did not have ID (mean [SD] age, 33.6 [16.1] years; 639 women [43.8%]). Only those individuals with CP and no comorbid ID had a higher risk of incident depression (HR, 1.44; 95% CI, 1.20-1.72) and anxiety (HR, 1.55; 95% CI, 1.28-1.87) than their matched controls.
结果:
1705例CP患者和5115例无CP成人的平均SD年龄为33.3岁(15.5岁),其中798例为女性(46.8%)。慢性阻塞性肺疾病患者抑郁的调整危险增加(危险比[HR], 1.28;95% CI, 1.09-1.51)和焦虑(HR, 1.40;95% CI, 1.21-1.63)与对照组比较。在我们考虑ID共病时,有363名成人同时患有ID(平均[SD]年龄32.1[13.2]岁;159名女性(47.6%)和1342名无ID的CP成人(平均[SD]年龄33.6[16.1]岁;639名女性[43.8%])。只有那些患有慢性阻滞性脑瘫且无共病ID的个体有更高的抑郁发病风险(HR, 1.44;95% CI, 1.20-1.72)和焦虑(HR, 1.55;95% CI, 1.28-1.87)比他们匹配的对照组。
Conclusions and Relevance:
Adults with CP have an increased risk of depression or anxiety. In particular, these results indicate that this association is driven largely by those individuals with CP with no co-occurring ID. Future work is needed in community-based samples to fully elucidate the causal mechanisms driving these associations.
结论:
患有脑瘫的成年人患抑郁症或焦虑症的风险增加。特别是,这些结果表明,这种关联很大程度上是由那些没有共同身份的CP患者驱动的。未来需要在基于社区的样本中开展工作,以充分阐明驱动这些关联的因果机制。



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