Abstract
Objective: Depression is a psychiatric disorder associated with poorer health outcomes. Inappropriate mechanical stress and aging are factors associated with developing cervical spondylosis. The connection between cervical spondylosis and depression is not developed. Methods: From the health insurance claims data of Taiwan, we identified 34,166 persons newly diagnosed with depression in 2000–2010 and 34,166 persons without the disorder frequency matched by sex, age and diagnosis year. Both cohorts were followed up to the end of 2013 to estimate incident cervical spondylosis. We further examined the risk of cervical spondylosis in depressed people taking antidepressants. Results: The incidence of cervical spondylosis was 1.8-fold greater in the depression cohort than in comparison cohort (9.46 vs. 5.36 per 1000 person-years), with an adjusted hazard ratio (aHR) of 1.79 (95% confidence interval (CI) = 1.66–1.92). The incidence of cervical spondylosis increased in patients who had taken medications of serotonin-specific reuptake inhibitors (SSRIs) or of non-SSRIs than in those without these medicines (9.13 or 11.5 vs. 6.54 per 1000 person-years, respectively). Conclusions: Patients with depression are at an increased risk of developing cervical spondylosis. Additional efforts in reducing the risk of cervical spondylosis might be required in depressed individuals undergoing anti-depressive therapy.
Highlights
IntroductionCervical spondylosis is a progressive degenerative disease of the cervical vertebral bodies and intervertebral discs in the neck, encompassing various clinical neurological presentations [1,2]
Cervical spondylosis is a progressive degenerative disease of the cervical vertebral bodies and intervertebral discs in the neck, encompassing various clinical neurological presentations [1,2].The prevalence of cervical spondylosis increases with age
Our findings demonstrated that individuals with a depressed mood are at an elevated risk of developing cervical spondylosis
Summary
Cervical spondylosis is a progressive degenerative disease of the cervical vertebral bodies and intervertebral discs in the neck, encompassing various clinical neurological presentations [1,2]. The prevalence of cervical spondylosis increases with age. 90% of adults aged >60 years have severe degeneration of cervical spine for at least one cervical level [3]. Symptomatic cervical spondylosis is a prevalent cause of disabilities for patients, impairing their quality of life [4]. The management of cervical spondylosis varies and is typically tailored to specific clinical circumstances, from conservative physical therapy for patients with mild symptoms to surgical decompression for those who have progressed to a cervical spondylosis myelopathy [5]. Because conservative and surgical treatments would just palliate discomfort, prevention and identification of the cause of cervical spondylosis would be the optimal strategy. Common factors associated with spondylotic changes included age, occupational characteristics, trauma, Down syndrome, and smoking [6]
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