See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/230665094 Allergic rhinitis in adolescence increases the risk of depression in later life: A nationwide population-based prospective cohort studyArticleinJournal of Affective Disorders · August 2012 Impact Factor: 3.38 · DOI: 10.1016/j.jad .2012.07.011 · Source: PubMed CITATIONS 17 READS 90 7 authors, including: Mu-Hong Chen Taipei Veterans General Hospital 48 PUBLICATIONS294CITATIONSSEE PROFILE Ying-Sheue Chen Taipei Veterans General Hospital 63PUBLICATIONS 570CITATIONSSEE PROFILE Kai-Lin Huang Taipei Veterans General Hospital 50 PUBLICATIONS606CITATIONSSEE PROFILE Ya Mei Bai Taipei Veterans General Hospital 169PUBLICATIONS 2,141CITATIONSSEE PROFILE All in-text references underlined in blueare linked to publications on ResearchGate, letting you access and read them immediately. Available from: Ya Mei Bai Retrieved on: 07 June 2016
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Allergic Rhinitis in Adolescence Increases the Risk of Depression in Later Life
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7/25/2019 Allergic Rhinitis in Adolescence Increases the Risk of Depression in Later Life
Allergic rhinitis in adolescence increases the risk of depression in later
life: A nationwide population-based prospective cohort study
Mu-Hong Chen a, Tung-Ping Su a,b, Ying-Sheue Chen a, Ju-Wei Hsu a, Kai-Lin Huang a,Wen-Han Chang a, Ya-Mei Bai a,b,n
a Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwanb Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
a r t i c l e i n f o
Article history:
Received 9 May 2012
Received in revised form
15 July 2012
Accepted 15 July 2012Available online 11 August 2012
Keywords:
Allergic rhinitis
Depression
Adolescence
Early adulthood
a b s t r a c t
Background: Many cross-sectional studies have suggested an association between allergic rhinitis (AR)
and depression, but the timing relationship was not determined. Using a nationwide population-based
prospective cohort study (1:4, age-/gender-matched), we hypothesized that AR in adolescence would
increase the risk of depression in later life.
Methods: In all, 1673 adolescents aged 12–15 that had AR between 1996 and 2000 were recruited for
our study. Cases of major depressive disorder and any depressive disorder that occurred to the end of
follow-up (December 31, 2010) were identified.
Result: Adolescents with AR had a higher prevalence of major depression (2.5% vs. 1.2%, po0.001) and
any depressive disorder (4.9% vs. 2.8%, po0.001) and an earlier onset of major depression (19.3172.91
vs. 20.4372.71 years, p¼0.038) and any depressive disorder (19.3572.63 vs. 20.4372.62 years,
p¼0.002) compared with the controls. The Cox regression model showed that adolescents with AR had
increased HRs of major depression (HR: 1.59, 95% CI: 1.02–2.50) and any depressive disorder (HR: 1.42,
95% CI: 1.04–1.93) after controlling residence location and comorbid allergic diseases.
Limitations: The prevalence of depressive disorder may be underestimated because only those who had
medicine-seeking behaviors were enrolled.
Conclusions: This first cohort case–control study showed an association between AR in early adoles-cence and depression in late adolescence and early adulthood. Our results suggested that allergic
responses played important roles in the development of depression.
& 2012 Elsevier B.V. All rights reserved.
1. Introduction
Allergic rhinitis (AR) is one of the most common chronic allergic
disorders and impairs the sufferers’ quality of life, sleep, and work
performance (Dykewicz and Hamilos, 2010). The prevalence of AR
in children and adolescents varies ranging from 1.4% to 39.7%, with
geographic difference (Strachan et al., 1997; Katelaris et al., 2012).
A trend toward an increasing prevalence of AR was noted world-
wide in the last decade (Arnedo-Pena et al., 2004; Lee et al., 2004).
The International Study of Asthma and Allergies in Childhood
(ISAAC) study estimated the time trend in the prevalence of AR
and its geographic variations in 30,046 schoolchildren aged 13–14
years, and showed that the prevalence of AR increased in the past
10 year, with a geographical effect (Arnedo-Pena et al., 2004). Lee
et al. (2004) compared 4448 and 3618 children in 2001 and 1995,
respectively, and found that the prevalence of life-time AR (42.4%
vs. 38.9%, po0.01) and current AR (37.4% vs. 35.1%, po0.03)
increased significantly. In Taiwan, a national study from 2000 to
2007 showed that the mean 1-year and overall 8-year prevalence
rates of AR in children and adolescents were 11.3% and 37.8%,
respectively (Hwang et al., 2010).
Depressive disorder occurs usually in late adolescence and early
adulthood (Paus et al., 2008). Some adverse events in early adoles-
cence, including physical diseases (i.e., arthritis and allergy), nega-
tive life events, and substance use increase the risk of depressive
disorder in late adolescence and early adulthood (Timonen et al.,
2002; Marmorstein, 2009; Tarakci et al., 2011; Espejo et al., 2012).
An association between allergies and depressive disorders has been
described in many reports. Previous evidence has shown that AR
could lead to some psychological problems in the sufferers. Using
the Symptom Checklist-90 (SCL-90) and the Satisfaction with Life
Scale, Bavbek et al. (2002) demonstrated that patients with AR had
significantly higher scores on all subscales of the SCL-90, especially
in the somatization and depression subscales, and lower scores for
life satisfaction, compared with the controls. Hurwitz et al.
Contents lists available at SciVerse ScienceDirect
journal homepage: www .elsevier.com/locate/jad
Journal of Affective Disorders
0165-0327/$ - see front matter & 2012 Elsevier B.V. All rights reserved.
http://dx.doi.org/10.1016/j.jad.2012.07.011
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Sec. 2, Taipei 11217, Taiwan. Tel./ fax: þ886 2 28344012.
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