Neuropsychiatric Comorbidity in Primary Hyperparathyroidism Before and After Parathyroidectomy: A Population Study.
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
accepted:
25
01
2022
pubmed:
6
3
2022
medline:
4
5
2022
entrez:
5
3
2022
Statut:
ppublish
Résumé
Primary hyperparathyroidism (PHPT) is often accompanied by neuropsychiatric symptoms. This study aimed to map out psychiatric comorbidity as reflected by medical treatment for psychiatric symptoms. A retrospective case-control analysis and a prospective cohort analysis of psychotropic drug utilization before and after PTX. A total of 8279 PHPT patients treated with parathyroidectomy in Sweden between July 1, 2008 and December 31, 2017 compared to a matched control cohort from the total population (n = 82,790). Information on filled prescriptions was collected from the Swedish Prescribed Drug Register (SDR). Socioeconomic data and diagnoses were added by linkage to national patient and population registers. Regression analyses were used to calculate relative drug utilization (OR) within 3 years prior to PTX and relative incidence of drug treatment (RR) within 3 years postoperatively. Utilization of antidepressant, anxiolytic and sleep medication was more comprehensive in PHPT patients compared with the controls prior to PTX. The most common were benzodiazepines [OR 1.40 (95% CI: 1.31-1.50)] and selective serotonin reuptake inhibitors [SSRI; OR 1.38 (95% CI: 1.30-1.47)]. Postoperatively, the excess prescription rate for anxiolytic benzodiazepines decreased within three years from a 30 to 19% excess and for benzodiazepines for sleep from 31 to 14%. No corresponding decrease in excess prescription rate was observed for SSRI. PHPT is associated with increased utilization of antidepressive medications and benzodiazepines before PTX. This study implies that psychiatric symptoms should be considered in PHPT patients and continuous medication should be reevaluated after PTX.
Sections du résumé
BACKGROUND
Primary hyperparathyroidism (PHPT) is often accompanied by neuropsychiatric symptoms. This study aimed to map out psychiatric comorbidity as reflected by medical treatment for psychiatric symptoms.
METHODS
A retrospective case-control analysis and a prospective cohort analysis of psychotropic drug utilization before and after PTX. A total of 8279 PHPT patients treated with parathyroidectomy in Sweden between July 1, 2008 and December 31, 2017 compared to a matched control cohort from the total population (n = 82,790). Information on filled prescriptions was collected from the Swedish Prescribed Drug Register (SDR). Socioeconomic data and diagnoses were added by linkage to national patient and population registers. Regression analyses were used to calculate relative drug utilization (OR) within 3 years prior to PTX and relative incidence of drug treatment (RR) within 3 years postoperatively.
RESULTS
Utilization of antidepressant, anxiolytic and sleep medication was more comprehensive in PHPT patients compared with the controls prior to PTX. The most common were benzodiazepines [OR 1.40 (95% CI: 1.31-1.50)] and selective serotonin reuptake inhibitors [SSRI; OR 1.38 (95% CI: 1.30-1.47)]. Postoperatively, the excess prescription rate for anxiolytic benzodiazepines decreased within three years from a 30 to 19% excess and for benzodiazepines for sleep from 31 to 14%. No corresponding decrease in excess prescription rate was observed for SSRI.
CONCLUSION
PHPT is associated with increased utilization of antidepressive medications and benzodiazepines before PTX. This study implies that psychiatric symptoms should be considered in PHPT patients and continuous medication should be reevaluated after PTX.
Identifiants
pubmed: 35246714
doi: 10.1007/s00268-022-06485-1
pii: 10.1007/s00268-022-06485-1
pmc: PMC9054898
doi:
Substances chimiques
Anti-Anxiety Agents
0
Benzodiazepines
12794-10-4
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1420-1430Informations de copyright
© 2022. The Author(s).
Références
Medicine (Baltimore). 2015 Jun;94(23):e931
pubmed: 26061318
Eur J Epidemiol. 2009;24(11):659-67
pubmed: 19504049
JAMA Surg. 2013 Feb;148(2):109-15
pubmed: 23560281
Acta Oncol. 2009;48(1):27-33
pubmed: 18767000
Am Surg. 2016 Sep;82(9):839-45
pubmed: 27670574
J Clin Endocrinol Metab. 2010 Sep;95(9):4324-30
pubmed: 20610600
Surgery. 2018 Feb;163(2):457-462
pubmed: 29133114
Ann Surg. 2011 Jan;253(1):131-7
pubmed: 21233611
J Clin Psychopharmacol. 2015 Jun;35(3):279-85
pubmed: 25853371
N Engl J Med. 2016 Mar 31;374(13):1203-5
pubmed: 27028909
Eur J Public Health. 2019 Aug 1;29(4):615-621
pubmed: 30608539
Pharmacoepidemiol Drug Saf. 2007 Jul;16(7):726-35
pubmed: 16897791
Clin Interv Aging. 2017 Apr 21;12:709-720
pubmed: 28461745
Aging Clin Exp Res. 2017 Feb;29(Suppl 1):15-21
pubmed: 27837463
J Surg Res. 2011 Oct;170(2):240-6
pubmed: 21571309
World J Surg. 2009 Nov;33(11):2244-55
pubmed: 19288279
Am J Surg. 2021 Sep;222(3):549-553
pubmed: 33551115
Eur J Epidemiol. 2019 Apr;34(4):423-437
pubmed: 30929112
Br J Surg. 2018 Feb;105(3):223-229
pubmed: 29405278
Eur J Epidemiol. 2016 Feb;31(2):125-36
pubmed: 26769609
J Clin Endocrinol Metab. 2007 Aug;92(8):3114-21
pubmed: 17535997
Osteoporos Int. 2017 Jan;28(1):1-19
pubmed: 27613721
J Bone Miner Res. 2021 Jan;36(1):3-11
pubmed: 33125769
Br J Surg. 2019 Dec;106(13):1810-1818
pubmed: 31595982
BMC Public Health. 2011 Jun 09;11:450
pubmed: 21658213
Best Pract Res Clin Endocrinol Metab. 2018 Dec;32(6):805-820
pubmed: 30665548