title: Depression and cholesteatoma: Preliminary findings from a nationwide population-based retrospective cohort study.
abstract: OBJECTIVE
  To estimate the risk of developing depressive disorder (DD) following diagnosis with cholesteatoma.
  
  
  METHODS
  In the study, we analyzed data from the Longitudinal Health Insurance Database of Taiwan. A total of 599 patients newly diagnosed with cholesteatoma between 1997 and 2007 were included with a comparison cohort of 2995 matched non-cholesteatoma enrollees. Each patient was followed for 3 years to identify the subsequent development of DD. Cox proportional hazard regression analysis was performed to compute adjusted 3-year hazard ratios.
  
  
  RESULTS
  The incidence of DD per thousand person-years was approximately twice as high among patients with cholesteatoma (11.32) as among those without cholesteatoma (5.85). After adjusting for potential confounders, patients with cholesteatoma were 1.99 times (95% CI=1.18-3.34, P=0.010) more likely to suffer from DD within 3 years compared to those without cholesteatoma.
  
  
  CONCLUSIONS
  This is the first study to demonstrate a link between cholesteatoma and subsequent DD within a three-year followup. We suggest that clinicians keep this critical but neglected issue in mind and carefully investigate the possibility of subsequent psychological problems among cholesteatoma patients.
authors: Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Otolaryngology, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Department of Otolaryngology, HsinChu Armed Forces General Hospital, HsinChu, Taiwan, ROC; Department of Otolaryngology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, ROC; Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors: Chin-Lung
authors: CL
authors: Kuo
authors: University of Texas at Austin, Austin, TX, USA.
authors: Nancy HsaoYen
authors: NH
authors: Chang
authors: Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Otolaryngology, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors: An-Suey
authors: AS
authors: Shiao
authors: Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Otolaryngology, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors: Chiang-Feng
authors: CF
authors: Lien
authors: Department of Health Care Administration, Taipei Medical University, 250 Wu-Hsing Street, Taipei, Taiwan.
authors: Hsiao-Ling
authors: HL
authors: Huang
authors: Department of Health Care Administration, Taipei Medical University, 250 Wu-Hsing Street, Taipei, Taiwan.
authors: Szu-Hai
authors: SH
authors: Lin
authors: School of Health Care Administration, Taipei Medical University, Taipei City, Taiwan, ROC. Electronic address: wpchcang@gmail.com.
authors: Wei-Pin
authors: WP
authors: Chang
mesh_terms: D016022:Case-Control Studies; D002781:Cholesteatoma / Q000453:epidemiology* / Q000523:psychology; D016208:Databases, Factual; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D013624:Taiwan / Q000453:epidemiology
keywords: Cholesteatoma; Depression; Population-based study