瑞典学者们探讨了抑郁后患者帕金森病(PD)的长期风险，并评估了二者的潜在混淆因素，结果表明，抑郁和PD发生有直接的相关性。研究者们超过20年随访发现二者显著的相关性结果提示，抑郁可能是PD的极早期前驱症状，或是诱发PD的危险因素。相关论文近期发表于《神经病学》(Neurology)杂志。

        该队列研究纳入140688例抑郁患者，以1:3的比例用巢式病例对照设计评估当前研究参数。在540811对兄弟姐妹的亚队列中调查两种诊断的潜在家族共聚现象。利用多变量校正统计学模型分析二者的相关性。

        结果显示，在中位随访的6.8年间(1至26.0年)，队列人群中共有3260例受试者被诊断为PD。PD的多变量校正比值比(OR)从抑郁第一年的3.2降至15年至25年后的1.5。

        在抑郁受试者中，反复住院是PD的独立危险因素(OR 1.4)。家族分析显示，兄弟姐妹抑郁与PD风险无显著的相关性(OR 1.1)。

        参考文献： Helena Gustafsson,et al. Published online Neurology before print May 20, 2015. doi: 10.1212/WNL.0000000000001684Neurology 10.1212/WNL.0000000000001684

Depression and subsequent risk of Parkinson disease
A nationwide cohort study
1. Helena Gustafsson, MD,
2. Anna Nordström, PhD and
3. Peter Nordström, PhD
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1. Correspondence to Prof. Peter Nordström: peter.nordstrom@germed.umu.se
1. Published online before print May 20, 2015, doi: 10.1212/WNL.0000000000001684Neurology 10.1212/WNL.0000000000001684
• Abstract
ABSTRACT
Objective: To investigate the long-term risk of Parkinson disease (PD) after depression and evaluate potential confounding by shared susceptibility to the 2 diagnoses.
Methods: The nationwide study cohort included 140,688 cases of depression, matched 1:3 using a nested case-control design to evaluate temporal aspects of study parameters (total, n = 562,631). Potential familial coaggregation of the 2 diagnoses was investigated in a subcohort of 540,811 sibling pairs. Associations were investigated using multivariable adjusted statistical models.
Results: During a median follow-up period of 6.8 (range, 0–26.0) years, 3,260 individuals in the cohort were diagnosed with PD. The multivariable adjusted odds ratio (OR) for PD was 3.2 (95% confidence interval [CI], 2.5–4.1) within the first year of depression, decreasing to 1.5 (95% CI, 1.1–2.0) after 15 to 25 years. Among participants with depression, recurrent hospitalization was an independent risk factor for PD (OR, 1.4; 95% CI, 1.1–1.9 for ≥5 vs 1 hospitalization). In family analyses, siblings' depression was not significantly associated with PD risk in index persons (OR, 1.1; 95% CI, 0.9–1.4).
Conclusions: The time-dependent effect, dose-response pattern for recurrent depression, and lack of evidence for coaggregation among siblings all indicate a direct association between depression and subsequent PD. Given that the association was significant for a follow-up period of more than 2 decades, depression may be a very early prodromal symptom of PD, or a causal risk factor.