Association between use of Chinese herbal medicine and depression risk in patients with rheumatoid arthritis

A nationwide retrospective cohort study

Hsin Hua Li, Hanoch Livneh, Chia Chou Yeh, How-Ran Guo, Ning Sheng Lai, Ming Chi Lu, Tzung Yi Tsai

Research output: Contribution to journalArticle

Abstract

Aim: Depression is a common mental disorder in rheumatoid arthritis (RA) patients and may provoke the onset of poor clinical prognoses. In view of this, whether or not the use of Chinese herbal medicines (CHMs) can alleviate the risk of depression still remains unclear. We conducted a longitudinal cohort study to evaluate the association between CHMs us and depression risk among RA patients. Method: Using claims data from the National Health Insurance of Taiwan, we identified 6609 newly diagnosed RA patients aged 20 years or older between 1998 and 2010. From this sample, we recruited 3386 CHM users and randomly selected 3223 controls using propensity scores matching from the remaining cases as the non-CHMs users. They were followed until the end of 2012 to record depression incidence. A Cox proportional hazards regression model was used to compute the hazard ratio (HR) of depression with regard to the use of CHMs. Results: During the 15-year follow-up, 249 CHM users and 314 non-CHM users developed depression, representing an incidence rate of 9.33 and 14.98, respectively, per 1000 person-years. We found that use of CHMs was associated with lower risk of depression by 38% (95% confidence interval 0.54-0.76). The most predominant effect was observed in those receiving CHMs for over 2 years (adjusted HR 0.34). Seven commonly prescribed CHMs could lessen the risk of depression: Chuan-niu-xi, Jie-geng, San-qi, Jia-wei-xia-yao-san, Dang-gui-nian-tong-tang, Zhi-gan-cao-tang, and Suan-zao-ren-tang. Conclusion: This study supports that adding CHMs into conventional therapy may prevent subsequent depression risk for RA patients.

Original languageEnglish
Pages (from-to)986-994
Number of pages9
JournalInternational Journal of Rheumatic Diseases
Volume22
Issue number6
DOIs
Publication statusPublished - 2019 Jun 1

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Herbal Medicine
Rheumatoid Arthritis
Cohort Studies
Retrospective Studies
Depression
Glycyrrhiza uralensis
Qi
Propensity Score
Incidence
National Health Programs
Taiwan
Proportional Hazards Models
Mental Disorders
Longitudinal Studies
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Rheumatology

Cite this

Li, Hsin Hua ; Livneh, Hanoch ; Yeh, Chia Chou ; Guo, How-Ran ; Lai, Ning Sheng ; Lu, Ming Chi ; Tsai, Tzung Yi. / Association between use of Chinese herbal medicine and depression risk in patients with rheumatoid arthritis : A nationwide retrospective cohort study. In: International Journal of Rheumatic Diseases. 2019 ; Vol. 22, No. 6. pp. 986-994.
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title = "Association between use of Chinese herbal medicine and depression risk in patients with rheumatoid arthritis: A nationwide retrospective cohort study",
abstract = "Aim: Depression is a common mental disorder in rheumatoid arthritis (RA) patients and may provoke the onset of poor clinical prognoses. In view of this, whether or not the use of Chinese herbal medicines (CHMs) can alleviate the risk of depression still remains unclear. We conducted a longitudinal cohort study to evaluate the association between CHMs us and depression risk among RA patients. Method: Using claims data from the National Health Insurance of Taiwan, we identified 6609 newly diagnosed RA patients aged 20 years or older between 1998 and 2010. From this sample, we recruited 3386 CHM users and randomly selected 3223 controls using propensity scores matching from the remaining cases as the non-CHMs users. They were followed until the end of 2012 to record depression incidence. A Cox proportional hazards regression model was used to compute the hazard ratio (HR) of depression with regard to the use of CHMs. Results: During the 15-year follow-up, 249 CHM users and 314 non-CHM users developed depression, representing an incidence rate of 9.33 and 14.98, respectively, per 1000 person-years. We found that use of CHMs was associated with lower risk of depression by 38{\%} (95{\%} confidence interval 0.54-0.76). The most predominant effect was observed in those receiving CHMs for over 2 years (adjusted HR 0.34). Seven commonly prescribed CHMs could lessen the risk of depression: Chuan-niu-xi, Jie-geng, San-qi, Jia-wei-xia-yao-san, Dang-gui-nian-tong-tang, Zhi-gan-cao-tang, and Suan-zao-ren-tang. Conclusion: This study supports that adding CHMs into conventional therapy may prevent subsequent depression risk for RA patients.",
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Association between use of Chinese herbal medicine and depression risk in patients with rheumatoid arthritis : A nationwide retrospective cohort study. / Li, Hsin Hua; Livneh, Hanoch; Yeh, Chia Chou; Guo, How-Ran; Lai, Ning Sheng; Lu, Ming Chi; Tsai, Tzung Yi.

In: International Journal of Rheumatic Diseases, Vol. 22, No. 6, 01.06.2019, p. 986-994.

Research output: Contribution to journalArticle

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T1 - Association between use of Chinese herbal medicine and depression risk in patients with rheumatoid arthritis

T2 - A nationwide retrospective cohort study

AU - Li, Hsin Hua

AU - Livneh, Hanoch

AU - Yeh, Chia Chou

AU - Guo, How-Ran

AU - Lai, Ning Sheng

AU - Lu, Ming Chi

AU - Tsai, Tzung Yi

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Aim: Depression is a common mental disorder in rheumatoid arthritis (RA) patients and may provoke the onset of poor clinical prognoses. In view of this, whether or not the use of Chinese herbal medicines (CHMs) can alleviate the risk of depression still remains unclear. We conducted a longitudinal cohort study to evaluate the association between CHMs us and depression risk among RA patients. Method: Using claims data from the National Health Insurance of Taiwan, we identified 6609 newly diagnosed RA patients aged 20 years or older between 1998 and 2010. From this sample, we recruited 3386 CHM users and randomly selected 3223 controls using propensity scores matching from the remaining cases as the non-CHMs users. They were followed until the end of 2012 to record depression incidence. A Cox proportional hazards regression model was used to compute the hazard ratio (HR) of depression with regard to the use of CHMs. Results: During the 15-year follow-up, 249 CHM users and 314 non-CHM users developed depression, representing an incidence rate of 9.33 and 14.98, respectively, per 1000 person-years. We found that use of CHMs was associated with lower risk of depression by 38% (95% confidence interval 0.54-0.76). The most predominant effect was observed in those receiving CHMs for over 2 years (adjusted HR 0.34). Seven commonly prescribed CHMs could lessen the risk of depression: Chuan-niu-xi, Jie-geng, San-qi, Jia-wei-xia-yao-san, Dang-gui-nian-tong-tang, Zhi-gan-cao-tang, and Suan-zao-ren-tang. Conclusion: This study supports that adding CHMs into conventional therapy may prevent subsequent depression risk for RA patients.

AB - Aim: Depression is a common mental disorder in rheumatoid arthritis (RA) patients and may provoke the onset of poor clinical prognoses. In view of this, whether or not the use of Chinese herbal medicines (CHMs) can alleviate the risk of depression still remains unclear. We conducted a longitudinal cohort study to evaluate the association between CHMs us and depression risk among RA patients. Method: Using claims data from the National Health Insurance of Taiwan, we identified 6609 newly diagnosed RA patients aged 20 years or older between 1998 and 2010. From this sample, we recruited 3386 CHM users and randomly selected 3223 controls using propensity scores matching from the remaining cases as the non-CHMs users. They were followed until the end of 2012 to record depression incidence. A Cox proportional hazards regression model was used to compute the hazard ratio (HR) of depression with regard to the use of CHMs. Results: During the 15-year follow-up, 249 CHM users and 314 non-CHM users developed depression, representing an incidence rate of 9.33 and 14.98, respectively, per 1000 person-years. We found that use of CHMs was associated with lower risk of depression by 38% (95% confidence interval 0.54-0.76). The most predominant effect was observed in those receiving CHMs for over 2 years (adjusted HR 0.34). Seven commonly prescribed CHMs could lessen the risk of depression: Chuan-niu-xi, Jie-geng, San-qi, Jia-wei-xia-yao-san, Dang-gui-nian-tong-tang, Zhi-gan-cao-tang, and Suan-zao-ren-tang. Conclusion: This study supports that adding CHMs into conventional therapy may prevent subsequent depression risk for RA patients.

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