title: High Risk of Depressive Disorders in Patients With Gout: A Nationwide Population-Based Cohort Study.
abstract: Metabolic abnormalities are common in patients with depressive disorders. However, the relationship between gout and depression is unclear. We explored the causal relationship among gout, antigout medication, and the associated risk of incidental depressive disorders.In this nationwide cohort study, we sampled data from the National Health Insurance Research Database to recruit 34,050 patients with gout as the gout cohort and 68,100 controls (without gout) as the nongout cohort. Our primary endpoint was the diagnosis of depressive disorders during follow-up. The overall study population was followed up until depression diagnosis, withdrawal from the NHI program, or the end of the study. The differences in demographic and clinical characteristics between both cohorts were determined using the Chi-square test for categorical variables and the t-test for continuous variables. Cox proportional hazard regression models were used to examine the effect of gout on the risk of depression, represented using the hazard ratio with the 95% confidence interval.Patients with gout exhibited a higher risk of depressive disorders than controls did. The risk of depressive disorders increased with age and was higher in female patients and those with hypertension, stroke, and coronary artery disease. Nonsteroidal antiinflammatory drug and prednisolone use was associated with a reduced risk of depression. Patients with gout who had received antigout medication exhibited a reduced risk of depressive disorders compared with nongout patients.Our findings support that gout increases the risk of depressive disorders, and that antigout medication use reduces the risk.
authors.affiliation: From the Department of Psychiatry, E-Da Hospital (T-CC, Y-CY); School of Medicine, I-Shou University, Kaohsiung (T-CC, Y-CY); Management Office for Health Data, China Medical University Hospital (C-LL); College of Medicine, China Medical University, Taichung (C-LL); Department of Nuclear Medicine, E-Da Hospital, I-Shou University, Kaohsiung (M-CL); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (J-AL, C-HK); Department of Radiation Oncology, China Medical University Hospital (J-AL); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).
authors.forename: Te-Chang
authors.initials: TC
authors.lastname: Changchien
authors.forename: Yung-Chieh
authors.initials: YC
authors.lastname: Yen
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Ming-Chia
authors.initials: MC
authors.lastname: Lin
authors.forename: Ji-An
authors.initials: JA
authors.lastname: Liang
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003866:Depressive Disorder / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006073:Gout / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D006074:Gout Suppressants / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D006074:Gout Suppressants