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李偉嘉 膀胱疼痛症候群/間質性膀胱炎與焦慮症具有關聯性 2014/1/29 上午 11:19:22 0
原 文 題  目 Bladder pain syndrome/Interstitial cystitis is associated with anxiety disorder
作  者 Kuo-Hsuan Chung,1,2 Shih-Ping Liu,3 Herng-Ching Lin,4 and Shiu-Dong Chung4,5*
出  處 Neurourol Urodyn. 2013 Aug 22:0. doi: 10.1002/nau.22382. [Epub ahead of print]
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評 論 焦慮症是生物、心理、與社會因素交互影響的產物。而間質性膀胱炎常好發於女性患者,不但常造成膀胱與周邊骨盆區域疼痛。在亞東醫院鍾旭東主任領銜之研究團隊裡,作者們利用台灣健保資料庫做出有趣的結果。膀胱疼痛症候群/間質性膀胱炎的患者相較於對照組有4.7倍的勝率罹患焦慮症。根據已知的學術推論,這種情形可能與基因遺傳具有相關性,如第13染色體症候群。另外自主神經系統失調或神經免疫反應等也可能參與其中,使得細胞激素升高與肥胖細胞反應等等。
abstract Aim: Recent research demonstrated that bladder pain syndrome/interstitial cystitis (BPS/IC) is associated with many coexisting physical and psychiatric conditions. In this study, we explored the potential association between anxiety disorder (AD) and BPS/IC using a case–controlled population-based approach in Taiwan. Methods: Data on the sampled subjects analyzed in this study were retrieved from the Longitudinal Health Insurance Database 2000. Our study included 396 female cases with BPS/IC and 1,980 randomly ed female controls. We excluded subjects who had a history of major psychosis (except AD) or a substance-related disorder. A conditional logistic regression was performed to calculate the odds ratio (OR) for the association between a previous diagnosis of AD and IC/BPS. Results: Of the 2,376 sampled subjects, 136 (5.72%) had received an AD diagnosis. AD was found in 64 (16.16%) cases and in 72 (3.64%) controls (P < 0.001). The conditional logistic regression analysis (conditioned on age group and the index year) suggested that compared to controls, the OR for prior AD among cases was 4.59 (95% confidence interval (CI)= 2.32–9.08, P < 0.001). After adjusting for chronic pelvic pain, irritable bowel syndrome, fibromyalgia, migraines, sicca syndrome, allergies, asthma, and an overactive bladder, the OR for prior AD among cases was 4.37 (95% CI 2.16–8.85, P < 0.001) compared to the controls. Conclusions: There was an association between AD and BPS/IC, even after taking demographic characteristics, medical co-morbidities, and substance-related disorders into consideration. Results of this study should alert clinicians to evaluate and monitor the presence of BPS/IC in patients with AD.
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