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Risk of benign paroxysmal positional vertigo in patients with depressive disorders: a nationwide population-based cohort study.

ABSTRACT: OBJECTIVE:The association between depression and benign paroxysmal positional vertigo (BPPV) remains debated. This study aimed to investigate the risk of BPPV in patients with depressive disorders. DESIGN:Longitudinal nationwide cohort study. SETTING:National health insurance research database in Taiwan. PARTICIPANTS:We enrolled 10?297 patients diagnosed with depressive disorders between 2000 and 2009 and compared them to 41?188 selected control patients who had never been diagnosed with depressive disorders (at a 1:4 ratio matched by age, sex and index date) in relation to the risk of developing BPPV. METHODS:The follow-up period was defined as the time from the initial diagnosis of depressive disorders to the date of BPPV, censoring or 31 December 2009. Cox proportional hazard regression analysis was used to investigate the risk of BPPV by sex, age and comorbidities, with HRs and 95% CIs. RESULTS:During the 9-year follow-up period, 44 (0.59 per 1000 person-years) patients with depressive disorders and 99 (0.33 per 1000 person-years) control patients were diagnosed with BPPV. The incidence rate ratio of BPPV among both cohorts calculating from events of BPPV per 1000 person-years of observation time was 1.79 (95% CI 1.23 to 2.58, p=0.002). Following adjustments for age, sex and comorbidities, patients with depressive disorders were 1.55 times more likely to develop BPPV (95%?CI 1.08 to 2.23, p=0.019) as compared with control patients. In addition, hyperthyroidism (HR=3.75, 95%?CI 1.67-8.42, p=0.001) and systemic lupus erythematosus (SLE) (HR=3.47, 95%?CI 1.07 to 11.22, p=0.038) were potential risk factors for developing BPPV in patients with depressive disorders. CONCLUSIONS:Patients with depressive disorders may have an increased risk of developing BPPV, especially those who have hyperthyroidism and SLE.

SUBMITTER: Hsu CL

PROVIDER: S-EPMC6475146 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Risk of benign paroxysmal positional vertigo in patients with depressive disorders: a nationwide population-based cohort study.

Hsu Chiao-Lin CL Tsai Shih-Jen SJ Shen Cheng-Che CC Lu Ti T Hung Yao-Min YM Hu Li-Yu LY

BMJ open 20190330 3

<h4>Objective</h4>The association between depression and benign paroxysmal positional vertigo (BPPV) remains debated. This study aimed to investigate the risk of BPPV in patients with depressive disorders.<h4>Design</h4>Longitudinal nationwide cohort study.<h4>Setting</h4>National health insurance research database in Taiwan.<h4>Participants</h4>We enrolled 10 297 patients diagnosed with depressive disorders between 2000 and 2009 and compared them to 41 188 selected control patients who had neve ...[more]

PMID: 30928959

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Project description:Benign paroxysmal positional vertigo (BPPV), the most common type of vertigo in the general population, is thought to be caused by dislodgement of otoliths from otolithic organs into the semicircular canals. In most cases, however, the cause behind the otolith dislodgement is unknown. Dental procedures, one of the most common medical treatments, are considered to be a possible cause of BPPV, although this has yet to be proven. This study is the first nationwide population-based case-control study conducted to investigate the correlation between BPPV and dental manipulation.Patients diagnosed with BPPV between January 1, 2007 and December 31, 2012 were recruited from the National Health Insurance Research Database in Taiwan. We further identified those who had undergone dental procedures within 1 month and within 3 months before the first diagnosis date of BPPV. We also identified the comorbidities of the patients with BPPV, including head trauma, osteoporosis, migraine, hypertension, diabetes, hyperlipidemia and stroke. These variables were then compared to those in age- and gender-matched controls.In total, 768 patients with BPPV and 1536 age- and gender-matched controls were recruited. In the BPPV group, 9.2% of the patients had undergone dental procedures within 1 month before the diagnosis of BPPV. In contrast, only 5.5% of the controls had undergone dental treatment within 1 month before the date at which they were identified (P = 0.001). After adjustments for demographic factors and comorbidities, recent exposure to dental procedures was positively associated with BPPV (adjusted odds ratio 1.77; 95% confidence interval 1.27-2.47). This association was still significant if we expanded the time period from 1 month to 3 months (adjusted odds ratio 1.77; 95% confidence interval 1.39-2.26).Our results demonstrated a correlation between dental procedures and BPPV. The specialists who treat patients with BPPV should consider dental procedures to be a risk factor, and dentists should recognize BPPV as a possible complication of dental treatment.

Dataset Information

Risk of benign paroxysmal positional vertigo in patients with depressive disorders: a nationwide population-based cohort study.

Publications

Risk of benign paroxysmal positional vertigo in patients with depressive disorders: a nationwide population-based cohort study.

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