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Increased risk of short‐term depressive disorder after Helicobacter pylori eradication: A population‐based nested cohort study
Author(s) -
Tsai ChiaFen,
Chen MuHong,
Wang YenPo,
Liu PeiYi,
Hou MingChih,
Lee FaYauh,
Lu ChingLiang
Publication year - 2021
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12824
Subject(s) - medicine , helicobacter pylori , depression (economics) , cohort , clarithromycin , incidence (geometry) , population , major depressive disorder , cohort study , comorbidity , psychiatry , physics , environmental health , amygdala , optics , economics , macroeconomics
Background Depressive disorder is a major psychiatric illness, and a disturbed brain‐gut‐microbiome axis may contribute to its pathophysiology. Chronic Helicobacter pylori ( H . pylori) infections are common in the general population and using multiple antibiotics is required for its eradication, which is associated with gut dysbiosis and may lead to depression. We aimed to evaluate the risk of psychiatrist‐diagnosed depression in patients with peptic ulcer diseases (PUD) receiving anti‐ H . pylori therapy. Materials and methods We collected data from the National Health Insurance Research Database (NHIRD) in Taiwan on PUD patients undergoing antibiotic treatment for H . pylori infection; patients and controls were matched for age, sex, income, level of urbanization, and comorbidities. Results Of the 1 million beneficiaries in the NHIRD, we identified 7087 patients for inclusion in the eradication cohort and 7087 matched non‐eradication controls with PUD. Antibiotic therapy is associated with a short‐term (<30 days) increase in the incidence of psychiatrist‐diagnosed depressive disorder ( p = 0.009, after multiple comparisons with Bonferroni correction) in the eradication cohort compared with the controls. Female (OR: 4.55, 95% CI: 1.53–13.48) PUD patients were more likely to display an increased risk of depression within 30 days after eradication therapy. Clarithromycin use was related to an elevated likelihood (OR: 3.14, 95% CI: 1.45–6.80) of subsequent depressive disorder within 30 days after eradication therapy. Conclusions Antibiotic eradication treatment for H . pylori infection is associated with a significant short‐term (less than 30 days) increase in the incidence of psychiatrist‐diagnosed depressive disorder, which can be overlooked by gastroenterologists and general practitioners.