title: Scoliosis and the Subsequent Risk of Depression: A Nationwide Population-based Cohort Study in Taiwan.
abstract: METHODS
  A retrospective cohort study by using the Taiwanese National Health Insurance Research Database (NHIRD).
  
  
  OBJECTIVE
  The purpose of this study is to conduct a large-scale cohort study to investigate the relationship between scoliosis and depression.
  
  
  BACKGROUND
  The association between scoliosis and depression has rarely been studied in Asian populations.
  
  
  METHODS
  The study cohort consisted of patients with diagnosis of scoliosis between 2003 and 2005 (N = 1409). A comparison cohort was constructed from five age- and gender-matched control subjects selected via random sampling (N = 7045). Data on adjusted hazard ratios (AHRs) of depression, 5-year freedom from depression rates, and risk factors for depression for the two cohorts were compared. All subjects were tracked for 5 years from the date of cohort entry to identify the development of depression. Cox proportional hazard regressions were performed to evaluate the 5-year freedom from depression rates. This study is supported by the University research grant without any study-specific conflicts.
  
  
  RESULTS
  During the 5-year follow-up period, 116 and 307 depression patients belonged to the scoliosis cohort and the comparison cohort, respectively. The AHRs of depression in patients with scoliosis was higher [AHR 1.95; 95% confidence interval (95% CI) 1.58-2.42; P < 0.001] than that of the controls during the 5-year follow-up. The risk of depression also demonstrated to be age-dependent for scoliosis patients. The middle-age (41-65 years old) and young adults (18-40 years old) scoliosis patients had higher AHRs (middle-age: AHR 2.45; 95% CI 1.67-3.59; P < 0.05; young adult: AHR 1.99; 95% CI 1.41-2.82; P < 0.05).
  
  
  CONCLUSIONS
  The population-based study indicated that patients with scoliosis may have an increased risk of depression. Health care professionals should consider designing and planning effective psychological prevention and treatment for scoliosis patients.
  
  
  METHODS
  4.
authors.affiliation: *Department of Healthcare Management, Yuanpei University, Hsin Chu†Department of Pharmacy, Wanfang Hospital‡Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University§School of Medicine, National Yang-Ming University, and Department of Orthopedics and Traumatology, Taipei Veterans General Hospital||Department of Education & Research, Taipei City Hospital¶Department of Information Management, Kang-Ning Junior College of Medical Care and Management#Department of Neurosurgery, Taipei Medical University-Wan Fang Medical Center**Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.
authors.forename: Wei-Pin
authors.initials: WP
authors.lastname: Chang
authors.forename: Yaleng
authors.initials: Y
authors.lastname: Lin
authors.forename: Hsiao-Ling
authors.initials: HL
authors.lastname: Huang
authors.forename: Hsing-Fang
authors.initials: HF
authors.lastname: Lu
authors.forename: Shih-Tien
authors.initials: ST
authors.lastname: Wang
authors.forename: Ying-Chen
authors.initials: YC
authors.lastname: Chi
authors.forename: Kuo-Sheng
authors.initials: KS
authors.lastname: Hung
authors.forename: Hsiang-Yin
authors.initials: HY
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D012600:Scoliosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult