Abstract
BackgroundIt has been shown that iron deficiency anemia (IDA) is associated with psychosocial consequences and psychiatric morbidity. However, the association between adults with IDA and psychiatric disorders has not been clarified. The purpose of this study was to investigate the psychiatric disorder morbidity of an IDA group in comparison with a non-IDA group and to examine the risk of psychiatric disorders in IDA patients treated with iron supplementation.MethodsAll study subjects were 20 years of age or over with newly diagnosed IDA enrolled in the Taiwan National Health Insurance Database from 2000 to 2012. We matched IDA and non-IDA subjects according to age and gender in a 1:2 ratio. Our primary outcome was diagnosis of psychiatric disorders and the patients were monitored until the end of 2013. A multivariate Cox proportional hazards regression model was used to explore the risk of psychiatric disorders in patients with IDA after adjustment for confounders, including demographic characteristics and comorbidities.ResultsThe adjusted hazard ratios (aHRs) of psychiatric disorders was 1.52 (95% CI = 1.45–1.59) in the IDA group compared with the non-IDA group. Among the different types of psychiatric disorders, the IDA group was associated with significantly higher incidence and risks of anxiety disorders, depression, sleep disorders, and psychotic disorders (p < 0.05). Furthermore, iron supplementation in IDA subjects was associated with a significantly lower risk of psychiatric disorders compared to non-iron supplementation in IDA patients.ConclusionsOur study indicates that IDA subjects had an increased risk of psychiatric disorders, regardless of other confounders. In IDA patients, iron supplementation was associated with a decreased risk of psychiatric disorders. Moreover, IDA patients receiving iron supplementation also had a lower risk of sleep disorders.
Highlights
It has been shown that iron deficiency anemia (IDA) is associated with psychosocial consequences and psychiatric morbidity
Risk factors for psychiatric disorders in the IDA group After adjustment for age, gender, income level, comorbidities, iron supplementation, and area, the adjusted hazard ratios (aHRs) of psychiatric disorders was 1.52 in the IDA group compared with the non-IDA group (Table 2)
Types of psychiatric disorders after IDA Among the different types of psychiatric disorders, the IDA group was associated with significantly higher incidence and risks of anxiety disorders, depression, psychotic disorders and sleep disorders (Table 3)
Summary
It has been shown that iron deficiency anemia (IDA) is associated with psychosocial consequences and psychiatric morbidity. The definition of iron deficiency is a shortage in the total content of iron in the body, which can lead to anemia as well as other health problems including: unusual fatigue [4], headaches and dizziness [5], restless legs [6], impaired immune function [7], pica [8], etc. An accumulating body of evidence currently indicates that iron has an important role in neurologic function and development. Current literature indicates that brain iron deficiency influences neurotransmitter (glutamate and γ-aminobutyric acid (GABA)) homeostasis, which causes deficits in memory, learning, and behavior, as well as emotional and psychological problems [10]. Previous research has found that anemia patients were more prevalent among those with cognitive derangement and neurological symptoms [11]
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