Risk of Psychiatric Disorders in Pulmonary Embolism: A Nationwide Cohort Study

Abstract

This study aims to investigate the association between pulmonary embolism (PE) and the risk of psychiatric disorders. A total of 21,916 patients aged ≥20 years with PE between January 1, 2000, and December 31, 2015, were selected from the National Health Insurance Research Database of Taiwan, along with 65,748 (1:3) controls matched for sex and age. Cox regression model revealed the crude HR was 1.539 (95% CI 1.481 to 1.599; p<0.001), and after adjusting all the covariates, the adjusted HR was 1.704 (95% CI 1.435 to 1.991, p<0.001), for the risk of psychiatric disorders in the PE cohort. PE was associated with the overall psychiatric disorders, dementia, anxiety, depression, and sleep disorders, after the exclusion of the psychiatric diagnoses in the first year. PE was associated with the overall psychiatric disorders, dementia, anxiety, and depression, after the exclusion of the psychiatric diagnoses in the first 5 years. The patients with PE were associated with psychiatric disorders. This finding could serve as a reminder to the physicians to be more watchful and aware in the long-term follow-up of patients with PE for their care and potential mental health problems.

Clinical Characteristics of Hyperandrogenism Include Hirsutism, Polycystic Ovary Syndrome, and Acne: Association with Psychiatric Disease in Women -A Nationwide Population-Based Cohort Study in Taiwan

“…This method could be viewed as a way to ensure that these diseases were recent-onset, with references from other studies on the association between clinical characteristics of hyperandrogenism and psychiatric health, utilizing the NHIRD. 17 …”

Factor V Leiden and the 10-year incidence of depression: A retrospective cohort study conducted in Germany

“…For example, it was observed in a study, including 753 participants from the Netherlands, that those diagnosed with pulmonary embolism were more likely to be subsequently tested positive for FVL compared with their counterparts without pulmonary embolism (Manten et al, 1996). Moreover, a nationwide cohort study of 21,916 adults living in Taiwan showed that, after adjusting for a wide range of covariates (e.g., gender, education and physical comorbidities), pulmonary embolism was positively and significantly associated with the incidence of depression (HR = 2.04) (Tzeng et al, 2019). The deleterious effects of pulmonary embolism on mental health may be, at least partially, explained by hypoxemia, brain hypoxia and inflammation (Tzeng et al, 2019).…”

“…However, it may be hypothesized that FVL could lead to depression via several mediating factors such as pulmonary embolism (Tzeng et al, 2019), obstetrical complications (e.g., miscarriage (Jacob et al, 2019Meinardi et al, 1999) and stillbirth (Gold et al, 2016;Hiltunen et al, 2010)) and early menopause in women (Georgakis et al, 2016;van Asselt et al, 2003), and being denied health and disability insurance (Bank et al, 2004;Tian et al, 2012). For example, FVL is a risk factor for stillbirth in pregnant women (Hiltunen et al, 2010), while stillbirth is known to have an negative impact on mental health (Gold et al, 2016).…”

Stimulants associated with reduced risk of hospitalization for motor vehicle accident injury in patients with obstructive sleep apnea-a nationwide cohort study

“…The NHIRD, which contains all the claims data of the beneficiaries, uses the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes to record the diagnoses [18]. The details of the program have been documented in previous studies [19][20][21][22][23][24].…”