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Depression and the Risk of Peptic Ulcer Disease: A Nationwide Population-Based Study
Chih-Chao Hsu1, Yi-Chao Hsu, Kuang-Hsi Chang
1From the Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung (C-CH.); Institute of Biomedical Sciences, Mackay Medical College, New Taipei City (Y-CH.); Department of Medical Research, Taichung Veterans General Hospital, Taichung (K-HC.); College of Medicine, The School of Chinese Medicine for Post Baccalaureate, I-Shou University (Yancho Campus) (C-YL.); Department of Chinese Medicine, E-DA Hospital, Kaohsiung (C-YL.); Division of Hepatology and Gastroenterology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei (L-WC.); Management Office for Health Data, China Medical University Hospital (C-LL); College of Medicine, China Medical University (C-LL); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (F-CS, C-HK.); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK), Department of Business Administration, Tunghai University, Taichung, Taiwan (C-SS).
Abstract:
The risk of peptic ulcer disease (PUD) among patients with depression has raised concern. This study determined the association between depression and the subsequent development of PUD using claims data.Patients newly diagnosed with depression in 2000 to 2010 were identified as depression cohort from the Taiwan National Health Insurance Research Database. The comparison cohort was randomly selected from subjects without depression, frequency matched by age and gender and diagnosis date, with a size 2-fold of the size of the depression cohort. The incidence of PUD was evaluated for both cohorts by the end of 2011. We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) of PUD using the Cox proportional hazards regression model.The depression cohort consisted of 23,536 subjects (129,751 person-years), and the comparison cohort consisted of 47,069 subjects (285,592 person-years). The incidence of PUD was 2-fold higher in the depression cohort than in the comparison cohort (33.2 vs 16.8 per 1000 person-years) with an age adjusted HR of 1.97 (95% CI = 1.89-2.06) or a multivariable adjusted HR of 1.35 (95% CI = 1.29-1.42).Depression might increase the risk of developing PUD. Prospective clinical studies of the relationship between depression and PUD are warranted.
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