Author: Tzu-Chen Lo (Taiwan)
Co-authors: Yu-Yen Chen
Purpose
To investigate the association between central serous chorioretinopathy (CSC) and the risk of developing depression. The risk factors associated with depression in CSC patients were also analyzed.
Setting/Venue
Population-based, retrospective cohort study.
Methods
Using the Taiwan National Health Insurance Research Database which was conducted from January 2001 to December 2013, a total of 25,939 subjects with CSC were enrolled in the CSC group and 103,756 subjects without CSC were enrolled in the control group. The two groups were matched on age, gender, and index year at a ratio of 1:4, and were followed until the end of 2013 to see whether they developed depression. Kaplan-Meier curves were generated to compare the cumulative hazard of subsequent depression between the two groups. A Cox regression analysis estimated the crude and adjusted hazard ratios (HRs) for depression. The confounders adjusted included age, gender, Charlson comorbidity index, insurance cost, urbanization level, hypertension, peptic ulcer, and smoking. Subsequently, we focused on the CSC group to investigate the risk factors leading to depression.
Results
The mean age of the cohort was 42.9 years. The CSC group had a significantly higher cumulative incidence of depression than the control group (6.0% vs. 4.6%, p value smaller than 0.0001). The Cox regression model indicated that the CSC group had a significantly higher risk for depression prior to and after adjustment of confounders (unadjusted HR= 1.32; adjusted HR = 1.29, both p value smaller than 0.0001). Within the CSC group, significant risk factors for depression included age, female gender, low income, first-onset CSC, peptic ulcer, and smoking. The recent use of steroids prior to CSC, by all routes of administration, also significantly increased the risk for depression. However, treatment of CSC reduced the risk of developing depression but did not reach a statistical significance.
Conlusions
Patients with CSC are at significantly greater risk of developing depression. Among CSC patients, age, female gender, low income, first-onset CSC, peptic ulcer, smoking, and recent use of steroids prior to CSC were significant risk factors for depression. Furthermore, treatment of CSC did not significantly reduce the risk for depression.
Financial Disclosure
The authors have no financial or other conflicts of interest to report.
Comments
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