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白癜风与美国成年人心理健康障碍住院治疗的关联。

Association of vitiligo with hospitalization for mental health disorders in US adults.

机构信息

Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Department of Dermatology, Mount Sinai Icahn School of Medicine, New York, NY, USA.

出版信息

J Eur Acad Dermatol Venereol. 2019 Jan;33(1):191-197. doi: 10.1111/jdv.15255. Epub 2018 Oct 12.

Abstract

BACKGROUND

Vitiligo has a complex bidirectional relationship with mental health (MH) disturbances. However, little is known about the relationship between vitiligo and MH emergencies.

OBJECTIVE

To examine the associations of vitiligo and MH hospitalizations in the United States.

METHODS

Data from the 2002 to 2012 National Inpatient Sample were analysed, including a ~20% sample of all US hospitalizations (n = 87 053 155 children and adults). Prevalence of hospitalization for MH disorders, their length of stay (LOS) and cost of care were determined for those with vitiligo compared to those without vitiligo.

RESULTS

Hospitalization for MH disorders occurred more commonly in those with vitiligo compared to those without vitiligo (4.17% vs. 2.18%). In multivariable logistic regression models, vitiligo was associated with higher odds of admission for any MH disorder [adjusted odds ratio (95% confidence interval): 1.69 (1.61-1.78)], including 14 of 15 MH disorders examined. Associated MH disorders included anxiety, schizophrenia, depression, suicidal risk, personality disorder, ADD/ADHD and conduct disorder, substance use disorder, childhood and adolescent psychiatric illnesses, alcohol-related disorders, adjustment disorders, developmental disorders, impulse control disorders, history of mental health disorders and miscellaneous mental health disorders. Vitiligo patients hospitalized with any MH disorder had higher geometric-mean (95% confidence interval) cost of inpatient care [$10 992 ($10 477-$11 507) vs. $10 082 ($9728-$10 435)] and LOS [5.6 (5.3-5.8) vs. 4.8 (4.6-4.9); P < 0.0001] compared to those without vitiligo, with $10.5 million excess annual costs from hospitalization with MH disorders in persons with vitiligo.

CONCLUSIONS

Persons with vitiligo had increased hospitalization for multiple MH disorders, which were associated with a considerable cost burden.

摘要

背景

白癜风与心理健康(MH)障碍之间存在复杂的双向关系。然而,对于白癜风与 MH 急症之间的关系,我们知之甚少。

目的

在美国,研究白癜风与 MH 住院之间的关系。

方法

对 2002 年至 2012 年国家住院患者样本数据进行分析,该数据包含美国约 20%的住院患者(n=87053155 名儿童和成人)。与无白癜风患者相比,确定有白癜风患者的 MH 障碍住院率、住院时间(LOS)和护理费用。

结果

与无白癜风患者相比,白癜风患者 MH 障碍住院的发生率更高(4.17%比 2.18%)。在多变量逻辑回归模型中,白癜风与任何 MH 障碍的住院几率更高相关[校正比值比(95%置信区间):1.69(1.61-1.78)],包括所检查的 15 种 MH 障碍中的 14 种。相关的 MH 障碍包括焦虑症、精神分裂症、抑郁症、自杀风险、人格障碍、ADD/ADHD 和品行障碍、物质使用障碍、儿童和青少年精神疾病、酒精相关障碍、适应障碍、发育障碍、冲动控制障碍、精神健康障碍史和各种精神健康障碍。患有任何 MH 障碍的白癜风住院患者的住院医疗费用中位数(95%置信区间)更高[10992 美元(10477 美元-11507 美元)比 10082 美元(9728 美元-10435 美元)],住院时间更长[5.6(5.3-5.8)比 4.8(4.6-4.9);P<0.0001],患有白癜风的患者因 MH 障碍住院导致每年额外增加 1050 万美元的费用。

结论

患有白癜风的患者 MH 障碍住院率更高,与多种 MH 障碍相关,这与相当大的费用负担有关。

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