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Risk of Parkinson disease after depression: a nationwide population-based study
Cheng-Che Shen1, Shih-Jen Tsai, Chin-Lin Perng
1From the Department of Psychiatry (C.-C.S.), Chiayi Branch, Taichung Veterans General Hospital; Department of Information Management (C.-C.S.), National Chung-Cheng University, Chiayi; Department of Psychiatry (S.-J.T., A.C.Y.), Division of Gastroenterology, Department of Medicine (C.-L.P.), and Department of Research and Medication (B.I.-T.K.), Taipei Veterans General Hospital; School of Medicine (S.-J.T., C.-L.P., B.I.-T.K., A.C.Y.), National Yang-Ming University, Taipei; and Center for Dynamical Biomarkers and Translational Medicine (A.C.Y.), National Central University, Chungli, Taiwan.
Objective:
To evaluate the risk of Parkinson disease (PD) among patients with depression by using the Taiwan National Health Insurance Research Database (NHIRD).
Methods:
We conducted a retrospective study of a matched cohort of 23,180 participants (4,634 patients with depression and 18,544 control patients) who were selected from the NHIRD. Patients were observed for a maximum of 10 years to determine the rates of new-onset PD, and Cox regression was used to identify the predictors of PD. We also examined the risk of PD after excluding patients who were diagnosed with PD within 2 or 5 years after their depression diagnosis. A logistic regression model was used to identify risk factors associated with PD onset in patients with depression.
Results:
During the 10-year follow-up period, 66 patients with depression (1.42%) and 97 control patients (0.52%) were diagnosed with PD. After adjusting for age and sex, patients with depression were 3.24 times more likely to develop PD (95% confidence interval 2.36-4.44, p < 0.001) compared with the control patients. After excluding patients who were diagnosed with PD within 2 or 5 years after their depression diagnosis, patients with depression had a higher hazard ratio for developing PD than the control patients. The odds ratios for age (1.09) and difficult-to-treat depression (2.18) showed that each is an independent risk factor for PD in patients with depression.
Conclusion:
The likelihood of developing PD is greater among patients with depression than patients without depression. Depression may be an independent risk factor for PD.
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