Ian Hidinger BS , Lan Kong MS, PhD , Amanda Ely MD
{"title":"儿童时期斜视手术时间与心理健康的关系:一项回顾性队列研究。","authors":"Ian Hidinger BS , Lan Kong MS, PhD , Amanda Ely MD","doi":"10.1016/j.jaapos.2024.103929","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the incidence of psychiatric diagnoses in relation to strabismus surgery timing among children with an early strabismus diagnosis who underwent surgery in childhood.</p></div><div><h3>Methods</h3><p>We conducted a retrospective cohort study using TriNetX network data from 2003-2023 on patients diagnosed with strabismus at ≤5 years of age and having strabismus surgery before 18 years of age. Cohort 1 comprised patients who underwent initial strabismus surgery at ≤6 years of age; cohort 2, patients with initial surgical intervention at ≥7 years of age. Incidence of mental health diagnoses from 7 until 18 years of age were compared between cohorts.</p></div><div><h3>Results</h3><p>In cohort 1, 59 of 688 patients (8.6%) of patients were diagnosed with at least 1 mental health disorder versus 123 of 693 patients (17.7%) in cohort 2 (risk ratio [RR] = 2.07; 95% CI, 1.546 to 2.77; <em>P</em> < 0.0001). Gender analysis showed that only males had a statistically significant increased rate of mental health diagnoses in cohort 2 versus cohort 1 (RR = 1.82; 95% CI, 1.284 to 2.577; <em>P</em> = 0.006). An increased risk for specific psychiatric diagnoses was found in cohort 2 versus cohort 1; anxiety disorders (RR = 2.19; 95% CI, 1.225-3.922; <em>P</em> = 0.0065), attention-deficit / hyperactivity disorder (RR = 2.18; 95% CI, 1.499-3.175; <em>P</em> < 0.0001), conduct disorders (RR = 2.81; 95% CI, 1.425-5.556; <em>P</em> = 0.0018), and adjustment disorders (RR = 2.07; 955% CI, 1.103-3.876; <em>P</em> = 0.0204). Depressive disorders showed no statistically significant difference between cohorts (RR = 1.00; 95% CI, 0.419-2.392; <em>P</em> = 0.9974).</p></div><div><h3>Conclusions</h3><p>Compared with children having early strabismus surgery, those having surgery at a later age after an early strabismus diagnosis at ≤5 years of age may be more likely to experience a mental health disorder during childhood, although it is unclear whether such disorders are a result of delayed surgery or a driver of the decision to opt for surgery rather than continued conservative management.</p></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"28 3","pages":"Article 103929"},"PeriodicalIF":1.2000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Associations of strabismus surgery timing in childhood with mental health: a retrospective cohort study\",\"authors\":\"Ian Hidinger BS , Lan Kong MS, PhD , Amanda Ely MD\",\"doi\":\"10.1016/j.jaapos.2024.103929\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>To investigate the incidence of psychiatric diagnoses in relation to strabismus surgery timing among children with an early strabismus diagnosis who underwent surgery in childhood.</p></div><div><h3>Methods</h3><p>We conducted a retrospective cohort study using TriNetX network data from 2003-2023 on patients diagnosed with strabismus at ≤5 years of age and having strabismus surgery before 18 years of age. Cohort 1 comprised patients who underwent initial strabismus surgery at ≤6 years of age; cohort 2, patients with initial surgical intervention at ≥7 years of age. Incidence of mental health diagnoses from 7 until 18 years of age were compared between cohorts.</p></div><div><h3>Results</h3><p>In cohort 1, 59 of 688 patients (8.6%) of patients were diagnosed with at least 1 mental health disorder versus 123 of 693 patients (17.7%) in cohort 2 (risk ratio [RR] = 2.07; 95% CI, 1.546 to 2.77; <em>P</em> < 0.0001). Gender analysis showed that only males had a statistically significant increased rate of mental health diagnoses in cohort 2 versus cohort 1 (RR = 1.82; 95% CI, 1.284 to 2.577; <em>P</em> = 0.006). An increased risk for specific psychiatric diagnoses was found in cohort 2 versus cohort 1; anxiety disorders (RR = 2.19; 95% CI, 1.225-3.922; <em>P</em> = 0.0065), attention-deficit / hyperactivity disorder (RR = 2.18; 95% CI, 1.499-3.175; <em>P</em> < 0.0001), conduct disorders (RR = 2.81; 95% CI, 1.425-5.556; <em>P</em> = 0.0018), and adjustment disorders (RR = 2.07; 955% CI, 1.103-3.876; <em>P</em> = 0.0204). Depressive disorders showed no statistically significant difference between cohorts (RR = 1.00; 95% CI, 0.419-2.392; <em>P</em> = 0.9974).</p></div><div><h3>Conclusions</h3><p>Compared with children having early strabismus surgery, those having surgery at a later age after an early strabismus diagnosis at ≤5 years of age may be more likely to experience a mental health disorder during childhood, although it is unclear whether such disorders are a result of delayed surgery or a driver of the decision to opt for surgery rather than continued conservative management.</p></div>\",\"PeriodicalId\":50261,\"journal\":{\"name\":\"Journal of Aapos\",\"volume\":\"28 3\",\"pages\":\"Article 103929\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Aapos\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S109185312400199X\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Aapos","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S109185312400199X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Associations of strabismus surgery timing in childhood with mental health: a retrospective cohort study
Purpose
To investigate the incidence of psychiatric diagnoses in relation to strabismus surgery timing among children with an early strabismus diagnosis who underwent surgery in childhood.
Methods
We conducted a retrospective cohort study using TriNetX network data from 2003-2023 on patients diagnosed with strabismus at ≤5 years of age and having strabismus surgery before 18 years of age. Cohort 1 comprised patients who underwent initial strabismus surgery at ≤6 years of age; cohort 2, patients with initial surgical intervention at ≥7 years of age. Incidence of mental health diagnoses from 7 until 18 years of age were compared between cohorts.
Results
In cohort 1, 59 of 688 patients (8.6%) of patients were diagnosed with at least 1 mental health disorder versus 123 of 693 patients (17.7%) in cohort 2 (risk ratio [RR] = 2.07; 95% CI, 1.546 to 2.77; P < 0.0001). Gender analysis showed that only males had a statistically significant increased rate of mental health diagnoses in cohort 2 versus cohort 1 (RR = 1.82; 95% CI, 1.284 to 2.577; P = 0.006). An increased risk for specific psychiatric diagnoses was found in cohort 2 versus cohort 1; anxiety disorders (RR = 2.19; 95% CI, 1.225-3.922; P = 0.0065), attention-deficit / hyperactivity disorder (RR = 2.18; 95% CI, 1.499-3.175; P < 0.0001), conduct disorders (RR = 2.81; 95% CI, 1.425-5.556; P = 0.0018), and adjustment disorders (RR = 2.07; 955% CI, 1.103-3.876; P = 0.0204). Depressive disorders showed no statistically significant difference between cohorts (RR = 1.00; 95% CI, 0.419-2.392; P = 0.9974).
Conclusions
Compared with children having early strabismus surgery, those having surgery at a later age after an early strabismus diagnosis at ≤5 years of age may be more likely to experience a mental health disorder during childhood, although it is unclear whether such disorders are a result of delayed surgery or a driver of the decision to opt for surgery rather than continued conservative management.
期刊介绍:
Journal of AAPOS presents expert information on children''s eye diseases and on strabismus as it affects all age groups. Major articles by leading experts in the field cover clinical and investigative studies, treatments, case reports, surgical techniques, descriptions of instrumentation, current concept reviews, and new diagnostic techniques. The Journal is the official publication of the American Association for Pediatric Ophthalmology and Strabismus.