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Risk of psychiatric disorders following gastroesophageal reflux disease: A nationwide population-based cohort study

  • Author Footnotes
    1 Zi-Hong You and Chin-Lin Perng contributed equally to this manuscript.
    Zi-Hong You
    Footnotes
    1 Zi-Hong You and Chin-Lin Perng contributed equally to this manuscript.
    Affiliations
    Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Chia-Yi Branch, Chia-Yi, Taiwan

    Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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  • Author Footnotes
    1 Zi-Hong You and Chin-Lin Perng contributed equally to this manuscript.
    Chin-Lin Perng
    Footnotes
    1 Zi-Hong You and Chin-Lin Perng contributed equally to this manuscript.
    Affiliations
    Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    School of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Li-Yu Hu
    Affiliations
    Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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  • Ti Lu
    Affiliations
    Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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  • Pan-Ming Chen
    Affiliations
    Department of Psychiatry, Yuanshan & Su'ao Branch, Taipei Veterans General Hospital, Yilan, Taiwan
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  • Albert C. Yang
    Affiliations
    School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Shih-Jen Tsai
    Affiliations
    School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Yi-Shin Huang
    Affiliations
    Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    School of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Hon-Jhe Chen
    Correspondence
    Corresponding author at: Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City 81362, Taiwan. Tel.: +886 7 3422121 4901; fax: +886 7 3422288.
    Affiliations
    Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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  • Author Footnotes
    1 Zi-Hong You and Chin-Lin Perng contributed equally to this manuscript.

      Highlights

      • GERD may increase the risks of depressive, anxiety, and sleep disorders.
      • The development of psychiatric disorders may be the result of an inflammatory process caused by GERD.
      • Clinicians should pay particular attention to psychiatric comorbidities in GERD patients.

      Abstract

      Background

      Recent studies have shown that the peripheral inflammation may cause the up-regulation of central nervous system inflammation and therefore possibly plays a vital role in the pathophysiology of subsequent psychiatric disorders.

      Objective

      We explored the relationship between gastroesophageal reflux disease (GERD) and the subsequent development of psychiatric disorders including schizophrenia as well as bipolar, depressive, anxiety, and sleep disorders.

      Methods

      We investigated patients who were diagnosed with GERD according to the data in the Taiwan National Health Insurance Research Database. A comparison cohort comprised patients without GERD who were matched according to age and sex. The incidence rate and the hazard ratios (HRs) of subsequent new-onset psychiatric disorders were calculated for both cohorts, based on the diagnoses of psychiatrists.

      Results

      The GERD cohort consisted of 3813 patients, and the comparison cohort comprised 15,252 matched control patients without GERD. The risks of depressive disorder (HR = 3.37, 95% confidence interval [CI] = 2.49–4.57), anxiety disorder (HR = 2.99, 95% CI = 2.12–4.22), and sleep disorder (HR = 2.69, 95% CI = 1.83–3.94), were higher in the GERD cohort than in the comparison cohort. In addition, the incidence of newly diagnosed depressive, anxiety, and sleep disorders remained significantly increased in all of the stratified follow-up durations (0–1, ≥1 year).

      Conclusions

      GERD may increase the risks of subsequent depressive, anxiety, and sleep disorders. These psychiatric disorders have a negative effect on people's quality of life. Clinicians should pay a particular attention to psychiatric comorbidities in GERD patients.

      Keywords

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