Epidemiology and risk of psychiatric disorders in patients with polymyositis and dermatomyositis: a nationwide population-based cohort study in Taiwan
Objectives To evaluate the incidence and risk factors for psychiatric disorders, including depression and anxiety, and assess the risk of suicide in patients with polymyositis (PM) and dermatomyositis (DM).Design Retrospective cohort study.Setting Data were obtained from Taiwan’s National Health Ins...
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BMJ Publishing Group
2025-05-01
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| Series: | BMJ Open |
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| author | Chin-Fang Su Yu-Sheng Chang Fang-Yi Wu I-Ping Lee Yao-Tung Lee Jui-Hung Kao Sheng-Hong Lin |
| author_facet | Chin-Fang Su Yu-Sheng Chang Fang-Yi Wu I-Ping Lee Yao-Tung Lee Jui-Hung Kao Sheng-Hong Lin |
| author_sort | Chin-Fang Su |
| collection | DOAJ |
| description | Objectives To evaluate the incidence and risk factors for psychiatric disorders, including depression and anxiety, and assess the risk of suicide in patients with polymyositis (PM) and dermatomyositis (DM).Design Retrospective cohort study.Setting Data were obtained from Taiwan’s National Health Insurance Research Database (NHIRD) between 2000 and 2018.Participants A total of 3477 patients with PM/DM and 13 908 age- and sex-matched non-PM/DM controls were included in the study.Primary and secondary outcome measures The primary outcome was the incidence and risk of psychiatric disorders in patients with PM/DM compared with controls. Secondary outcomes included the identification of risk factors for psychiatric disorders, mortality and suicide risk in the PM/DM cohort.Results The incidence rate ratio (IRR) of psychiatric disorders was significantly higher in the PM/DM cohort than in controls (IRR 1.62, 95% CI 1.39 to 1.89), with depression being the most prevalent disorder (IRR 2.25, 95% CI 1.83 to 2.75). Key risk factors included female sex, intravenous steroid therapy, and high-dose oral steroid use. Additionally, the PM/DM cohort exhibited a higher mortality rate (IRR 3.4, 95% CI 3.15 to 3.67) and elevated suicide risk (IRR 1.99, 95% CI 0.96 to 3.86) compared with controls.Conclusion Patients with PM/DM face a significantly higher risk of psychiatric disorders, mortality and suicide. Integrating mental healthcare into the routine management of PM/DM is crucial to improving patient outcomes and reducing mortality. Future research should focus on the impact of early psychiatric interventions on survival outcomes in this population. |
| format | Article |
| id | doaj-art-c585bf0c953e48e9be13c650d9d84fed |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-c585bf0c953e48e9be13c650d9d84fed2025-08-20T03:12:46ZengBMJ Publishing GroupBMJ Open2044-60552025-05-0115510.1136/bmjopen-2024-097829Epidemiology and risk of psychiatric disorders in patients with polymyositis and dermatomyositis: a nationwide population-based cohort study in TaiwanChin-Fang Su0Yu-Sheng Chang1Fang-Yi Wu2I-Ping Lee3Yao-Tung Lee4Jui-Hung Kao5Sheng-Hong Lin6Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taipei Medical University, Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, TaiwanDivision of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taipei Medical University, Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, TaiwanDepartment of Data Science, College of Arts and Sciences, American University, Washington, District of Columbia, USADivision of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taipei Medical University, Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, TaiwanDepartment of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, TaiwanDivision of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taipei Medical University, Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, TaiwanDivision of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taipei Medical University, Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, TaiwanObjectives To evaluate the incidence and risk factors for psychiatric disorders, including depression and anxiety, and assess the risk of suicide in patients with polymyositis (PM) and dermatomyositis (DM).Design Retrospective cohort study.Setting Data were obtained from Taiwan’s National Health Insurance Research Database (NHIRD) between 2000 and 2018.Participants A total of 3477 patients with PM/DM and 13 908 age- and sex-matched non-PM/DM controls were included in the study.Primary and secondary outcome measures The primary outcome was the incidence and risk of psychiatric disorders in patients with PM/DM compared with controls. Secondary outcomes included the identification of risk factors for psychiatric disorders, mortality and suicide risk in the PM/DM cohort.Results The incidence rate ratio (IRR) of psychiatric disorders was significantly higher in the PM/DM cohort than in controls (IRR 1.62, 95% CI 1.39 to 1.89), with depression being the most prevalent disorder (IRR 2.25, 95% CI 1.83 to 2.75). Key risk factors included female sex, intravenous steroid therapy, and high-dose oral steroid use. Additionally, the PM/DM cohort exhibited a higher mortality rate (IRR 3.4, 95% CI 3.15 to 3.67) and elevated suicide risk (IRR 1.99, 95% CI 0.96 to 3.86) compared with controls.Conclusion Patients with PM/DM face a significantly higher risk of psychiatric disorders, mortality and suicide. Integrating mental healthcare into the routine management of PM/DM is crucial to improving patient outcomes and reducing mortality. Future research should focus on the impact of early psychiatric interventions on survival outcomes in this population.https://bmjopen.bmj.com/content/15/5/e097829.full |
| spellingShingle | Chin-Fang Su Yu-Sheng Chang Fang-Yi Wu I-Ping Lee Yao-Tung Lee Jui-Hung Kao Sheng-Hong Lin Epidemiology and risk of psychiatric disorders in patients with polymyositis and dermatomyositis: a nationwide population-based cohort study in Taiwan BMJ Open |
| title | Epidemiology and risk of psychiatric disorders in patients with polymyositis and dermatomyositis: a nationwide population-based cohort study in Taiwan |
| title_full | Epidemiology and risk of psychiatric disorders in patients with polymyositis and dermatomyositis: a nationwide population-based cohort study in Taiwan |
| title_fullStr | Epidemiology and risk of psychiatric disorders in patients with polymyositis and dermatomyositis: a nationwide population-based cohort study in Taiwan |
| title_full_unstemmed | Epidemiology and risk of psychiatric disorders in patients with polymyositis and dermatomyositis: a nationwide population-based cohort study in Taiwan |
| title_short | Epidemiology and risk of psychiatric disorders in patients with polymyositis and dermatomyositis: a nationwide population-based cohort study in Taiwan |
| title_sort | epidemiology and risk of psychiatric disorders in patients with polymyositis and dermatomyositis a nationwide population based cohort study in taiwan |
| url | https://bmjopen.bmj.com/content/15/5/e097829.full |
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