title: Pre-existing hyperlipidaemia increased the risk of new-onset anxiety disorders after traumatic brain injury: a 14-year population-based study.
abstract: OBJECTIVE
  Anxiety disorders (ADs) are common after traumatic brain injury (TBI). However, the risk factors of new-onset ADs remain unclear. This study was aimed at evaluating the incidence and risk factors for new-onset ADs, including pre-existing hyperlipidaemia and three major comorbidities (diabetes mellitus, hypertension and cardiovascular disease), in patients with TBI.
  
  
  METHODS
  A matched cohort study was conducted using the Taiwan Longitudinal Health Insurance Database between January 1997 and December 2010.
  
  
  METHODS
  A total of 3822 participants (1274 patients with TBI with hyperlipidaemia and 2548 age-matched and gender-matched patients with TBI without hyperlipidaemia).
  
  
  METHODS
  The incidence and HRs for the development of new-onset ADs after TBI were compared between the two groups.
  
  
  RESULTS
  The overall incidence rate of new-onset ADs for patients with TBI with hyperlipidaemia is 142.03/10 000 person-years (PYs). Patients with TBI with hyperlipidaemia have a 1.60-fold incidence rate ratio (p<0.0001) and increased HR of ADs (1.58, 95% CI 1.24 to 2.02) compared with those without hyperlipidaemia. The incidence rates of ADs for males and females with hyperlipidaemia, respectively, were 142.12 and 292.32/10 000 PYs, which were higher than those without hyperlipidaemia (93.03 and 171.68/10 000 PYs, respectively). Stratified by age group, hyperlipidaemia is a risk factor of ADs for patients with TBI aged 65 years or younger.
  
  
  CONCLUSIONS
  Pre-existing hyperlipidaemia is an independent predictor of new-onset ADs in patients with TBI, even when controlling for other demographic and clinical variables. Female patients with pre-existing hyperlipidaemia had significantly higher risk of new-onset ADs than males, especially between the ages of 35 and 65 years.
authors.affiliation: Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Chung-Han
authors.initials: CH
authors.lastname: Ho
authors.affiliation: Department of Psychiatry, Chi-Mei Medical Center, Tainan, Taiwan Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
authors.forename: Kuang-Yang
authors.initials: KY
authors.lastname: Hsieh
authors.affiliation: Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Fu-Wen
authors.initials: FW
authors.lastname: Liang
authors.affiliation: Department of Psychiatry, National Cheng-Kung University, Tainan, Taiwan.
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Li
authors.affiliation: Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
authors.affiliation: Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan Department of Neurosurgery, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Chung-Ching
authors.initials: CC
authors.lastname: Chio
authors.affiliation: Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Chin-Hung
authors.initials: CH
authors.lastname: Chang
authors.affiliation: Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan Department of Neurosurgery, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Jinn-Rung
authors.initials: JR
authors.lastname: Kuo
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000209:etiology*; D001930:Brain Injuries / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012107:Research Design; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: Psychiatry