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Original research
Risk of psychiatric disorders in pulmonary embolism: a nationwide cohort study
  1. Nian-Sheng Tzeng1,2,
  2. Chi-Hsiang Chung3,4,5,
  3. Shan-Yueh Chang6,7,
  4. Chin-Bin Yeh1,
  5. Ru-Band Lu1,8,
  6. Hsin-An Chang1,2,
  7. Yu-Chen Kao1,9,
  8. Yu-Ching Chou4,
  9. Hui-Wen Yeh1,10,
  10. Wu-Chien Chien3,4,11
  1. 1 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
  2. 2 Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
  3. 3 Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
  4. 4 School of Public Health, National Defense Medical Center, Taipei, Taiwan
  5. 5 Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
  6. 6 Division of Chest and Critical Medicine, Department of Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
  7. 7 Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
  8. 8 Department of Psychiatry, College of Medicine & Hospital, National Chen-Gung University, Tainan, Taiwan
  9. 9 Department of Psychiatry, Tri-Service General Hospital, Songshan Branch, Taipei, Taiwan
  10. 10 Institute of Bioinformatics and System Biology, National Chiao Tung University, Hsinchu, Taiwan
  11. 11 Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
  1. Correspondence to Professor Wu-Chien Chien, Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; chienwu{at}ndmctsgh.edu.tw

Abstract

This study aims to investigate the association between pulmonary embolism (PE) and the risk of psychiatric disorders. A total of 21,916 patients aged ≥20 years with PE between January 1, 2000, and December 31, 2015, were selected from the National Health Insurance Research Database of Taiwan, along with 65,748 (1:3) controls matched for sex and age. Cox regression model revealed the crude HR was 1.539 (95% CI 1.481 to 1.599; p<0.001), and after adjusting all the covariates, the adjusted HR was 1.704 (95% CI 1.435 to 1.991, p<0.001), for the risk of psychiatric disorders in the PE cohort. PE was associated with the overall psychiatric disorders, dementia, anxiety, depression, and sleep disorders, after the exclusion of the psychiatric diagnoses in the first year. PE was associated with the overall psychiatric disorders, dementia, anxiety, and depression, after the exclusion of the psychiatric diagnoses in the first 5 years. The patients with PE were associated with psychiatric disorders. This finding could serve as a reminder to the physicians to be more watchful and aware in the long-term follow-up of patients with PE for their care and potential mental health problems.

  • pulmonary embolism
  • risk
  • psychopathology
  • mental disorders

http://dx.doi.org/10.1136/jim-2018-000910

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    Footnotes

    • Contributors N-ST and W-CC conceived of the study, participated in its design and coordination, data interpretation, performed the statistical analysis, and drafted the manuscript. W-CC, C-HC, S-YC, C-BY, and H-WY participated in the design of the study and data interpretation. H-AC and Y-CK participated in the design of the study and data interpretation. R-BL and Y-CC participated in the statistical analysis and data interpretation. N-ST wrote the paper. All authors have read and approved the final manuscript as submitted.

    • Funding This work was supported by the Tri-Service General Hospital Research Foundation (Grant Reference Numbers TSGH-C105-130, TSGH-C106-106, TSGH- C107-004, TSGH-C107-106, TSGH-C108-003, and TSGH-C108-151), and the Medical Affairs Bureau, Ministry of Defense, Taiwan (MAB-107-084).

    • Competing interests None declared.

    • Ethics approval The Institutional Review Board of the Tri-Service General Hospital (IRB No. 1-104-05-145) approved this study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Not required.

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    © American Federation for Medical Research 2019. No commercial re-use. See rights and permissions. Published by BMJ.