OBJECTIVE:

The temporal relationship between Tourette syndrome (TS) and depression is unclear. This cohort study evaluates the relationship between TS and depression in Taiwan.

METHODS:

Claims data from the Taiwan National Health Insurance database were used to conduct retrospective cohort analyses. The study cohort contained 1337 TS patients who were frequency matched by sex, age, urbanization of residence area, parental occupation, and baseline year with 10 individuals without TS. Cox's proportional hazard regression analysis was conducted to estimate the effects of TS on depression risk.

RESULTS:

In patients with TS, the risk of developing depression was significantly higher than in patients without TS (p value for log-rank test < .0001). After adjusting for potential confounding, the TS cohort was 4.85 times more likely to develop depression than the control cohort (HR = 4.85, 95% CI = 3.46-6.79).

CONCLUSIONS:

In Taiwan, patients with TS have a higher risk of developing depression. The findings of this study are compatible with studies from other countries. This study could provide an evidence to inform the prognosis for a child with TS. The mechanism between TS and increased depression risk requires further investigation.

This study examines the possible association between urinary tract infection (UTI) and urinary tract cancer (UTC). Data from the National Health Insurance system of Taiwan were used for the analysis. The UTI cohort included 70 116 patients who were diagnosedand recruited between 1997 and 2010. Each patient was randomly frequency-matched with two people without UTI from the generalpopulation based on their age, sex, and month of UTI diagnosis. Cox's proportional hazard regression analysis was used to estimate the effects of UTI on UTC risk until the end of follow-up on December 31, 2010. Patients with UTI had a significantly higher risk of developing UTC than healthy people (adjusted hazard ratio, 4.66; 95% confidence interval, 3.55-6.10). Further analyses indicated that risks are potentially related to the level of the lesion site. This study indicated that patients with UTI had a higher risk of developing UTC.

OBJECTIVE:

To evaluate the association between urinary tract stone (UTS) and urinary tract cancer (UTC) in Taiwanese patients, as the results of epidemiological studies about the relationship between UTS and the development of UTC remain inconclusive.

PATIENTS/SUBJECTS AND METHODS:

We conducted a population-based cohort study using data from the Taiwanese National Health Insurance system. The UTS cohort included 21 862 patients, and each patient was randomly frequency-matched for age, sex, and index year with two insured members of the general population who did not have UTS. Cox proportional hazard regression analysis was performed to estimate the effect of UTS on the risk of UTC.

RESULTS:

Patients with UTS were at a significantly higher risk of developing UTC compared with the comparison group (adjusted hazard ratio 4.66; 95% confidence interval 2.97-7.30). Women were at higher risk than men. Further analyses showed that the level of UTC was associated with that of UTS, and that the risk for UTC became more divergent for the two groups over time.

CONCLUSIONS:

Taiwanese patients with UTS, particularly women, had a higher risk for developing UTC than patients without UTS. The risk became more marked over time for this group.

BACKGROUND:

Population studies on trends of varicella and herpes zoster (HZ) associated with varicella zoster vaccination and climate is limited.

METHODS:

This study used insurance claims data to investigate the chronological changes in incident varicella and HZ associated with varicella zoster vaccination. Poisson regression was used to estimate the occurrence of varicella associated with the occurrence of HZ and vice versa by year, season, sex, temperature, and sunny hours.

RESULTS:

The varicella incidence declined from 7.14 to 0.76 per 1,000 person-years in 2000-2009, whereas the HZ incidence increased from 4.04 to 6.24 per 1,000 person-years. Females tended to have a higher risk than men for HZ (p<0.0001) but not varicella. The monthly mean varicella incidence was the lowest in September (160 cases) and the highest in January (425 cases), while the mean HZ incidence was lower in February (370 cases) and higher in August (470 cases). HZ was negatively associated with the incidence of varicella before and after the varicella zoster vaccination (p<0.001), increased 1.6% within one week post-vaccination. The effect of temperature on HZ was attenuated by 18.5% (p<0.0001) in association with vaccination. The varicella risk was positively associated with sun exposure hours, but negatively associated with temperature only before vaccination.

CONCLUSIONS:

The varicella vaccination is effective in varicella prevention, but the incidence of HZ increases after vaccination. HZ has a stronger association with temperature and UV than with seasonality while varicella risk associated with temperature and UV is diminished.