title: Increased risk of anxiety among patients with urolithiasis: A nationwide population-based cohort study.
abstract: OBJECTIVE
  To investigate whether patients with urolithiasis are at an increased risk of anxiety and depression.
  
  
  METHODS
  We used universal insurance claims data in Taiwan from 2000 to 2011 to identify patients with newly diagnosed urolithiasis (n = 32 617) and those without urolithiasis (n = 130 465). Incidences, hazard ratios, and incidence rate ratios of anxiety and depression were determined in both cohorts in terms of baseline demographic characteristics and comorbidities until December 2011.
  
  
  RESULTS
  The urolithiasis cohort yielded a higher incidence of anxiety (11.9 vs 6.91 per 1000 person-years) with an adjusted hazard ratio of 1.5 (95% confidence interval 1.42-1.57) than the non-urolithiasis cohort. The urolithiasis cohort also showed a higher incidence of depression (5.79 vs 3.95 per 1000 person-years) with an adjusted hazard ratio of 1.26 (95% confidence interval 1.18-1.35) than the non-urolithiasis cohort. Regardless of the patients' baseline comorbidities, patients with urolithiasis showed a higher incidence rate ratio of anxiety and depression than those without urolithiasis (with no comorbidities: adjusted hazard ratio 1.62, 95% confidence interval 1.49-1.76] for anxiety and adjusted hazard ratio 1.37, 95% confidence interval 1.23-1.54 for depression).
  
  
  CONCLUSIONS
  Urolithiasis is recurrent, and significantly associated with anxiety and depression. Therefore, urologists should diagnose patients suspected with this disease and provide proper medical care.
authors.affiliation: Department of Urology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chi-Shun
authors.initials: CS
authors.lastname: Lien
authors.affiliation: Department of Urology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chi-Ping
authors.initials: CP
authors.lastname: Huang
authors.affiliation: Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan.|Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chi-Jung
authors.initials: CJ
authors.lastname: Chung
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Urology, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chao-Hsiang
authors.initials: CH
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D052878:Urolithiasis / Q000453:epidemiology* / Q000523:psychology
keywords: National Health Insurance program; anxiety; depression; retrospective cohort study; urolithiasis