抗精神病药物治疗的日本精神分裂症妇女激素替代疗法的乳腺癌风险：一项回顾性队列研究

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-03-26 DOI:10.1016/j.jpsychires.2025.03.048

Ryosuke Ota , Atsushi Hirata , Takeo Hata , Masami Nishihara , Akira Ashida , Tetsufumi Kanazawa , Takahiro Katsumata

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引用次数: 0

摘要

目的本研究旨在确定接受抗精神病药物治疗的精神分裂症患者发生乳腺癌的危险因素。重点是了解基线患者特征和治疗因素如何影响这一人群的乳腺癌风险。方法采用日本全国理赔数据库进行回顾性队列研究，纳入12479例接受抗精神病药物治疗的精神分裂症患者。主要结果是乳腺癌的发展。采用多变量Cox回归分析确定独立危险因素，并采用折刀法和弹性网法进行敏感性分析。结果12479例患者中，22例在随访期间发生乳腺癌。基线年龄38岁及以上(风险比（HR) = 4.87, 95%可信区间(CI) = 1.41 ~ 16.87, p = 0.013）和使用孕激素（HR = 4.47, 95% CI = 1.04 ~ 19.18, p = 0.044）是乳腺癌发病的独立危险因素。敏感性分析证实了这些发现的稳健性，尽管该研究有限的事件数量突出了hr的潜在变异性。结论某些治疗因素，尤其是孕激素的使用可能会增加精神分裂症患者接受抗精神病药物治疗的乳腺癌风险。鉴于这些发现，可能需要仔细考虑治疗计划，包括激素替代治疗的剂量和持续时间以及抗精神病药物治疗的调整。需要进一步的研究来阐明精神障碍、治疗因素和乳腺癌风险之间的相互作用。

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Breast cancer risk of hormone replacement therapy in Japanese women with schizophrenia on antipsychotic treatment: A retrospective cohort study

Purpose

This study aimed to identify the risk factors for breast cancer onset in patients with schizophrenia who are receiving antipsychotic treatment. The focus was on understanding how baseline patient characteristics and treatment factors influence breast cancer risk in this population.

Methods

A retrospective cohort study was conducted using a nationwide claims database in Japan, including 12,479 patients with schizophrenia who were receiving antipsychotic medications. The primary outcome was the development of breast cancer. Multivariate Cox regression analysis was employed to identify independent risk factors, with sensitivity analyses conducted using the jackknife and elastic net methods.

Results

Among the 12,479 patients, 22 developed breast cancer during the follow-up period. Baseline age of 38 years or older (hazard ratio (HR) = 4.87, 95 % confidence interval (CI) = 1.41–16.87, p = 0.013) and the use of progestogens (HR = 4.47, 95 % CI = 1.04–19.18, p = 0.044) were identified as independent risk factors for breast cancer onset. Sensitivity analyses confirmed the robustness of these findings, although the study's limited number of events highlighted potential variability in the HRs.

Conclusion

The results suggest that certain treatment factors, particularly the use of progestogens, may increase the risk of breast cancer in patients with schizophrenia who are receiving antipsychotic treatment. Given these findings, careful consideration of treatment plans, including the dosage and duration of hormone replacement therapy and adjustments in antipsychotic treatment, may be warranted. Further research is needed to clarify the interactions between mental disorders, treatment factors, and breast cancer risk.

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;