Patients with primary immune thrombocytopenia (ITP) suffer from reduced survival and quality of life, but the underlying reasons for this are largely undescribed. Mental health and the use of psychotropic drugs in ITP is unknown. We investigated the risk of hospital registered mental health events including fatigue and the use of psychotropic drugs in adult patients with ITP compared with the general population, using nationwide registry-data. We identified 3,749 patients with ITP and 149,849 age-sex matched general population comparators in the Danish Health Registries in the period 1997-2016. The median age was 60 years (IQR 40-73) and 53% were women. We followed the individuals for incident mental health events and estimated the use of psychotropic drugs over calendar-years and in temporal relation to diagnosis of ITP. The first year cumulative incidence of any mental health event was 2.3% (95% confidence interval, 1.9-2.9) in patients and 0.7% (0.6-0.7) in comparators, yielding an adjusted cause-specific hazard ratio (csHR) of 3.57 (2.84-4.50). The corresponding estimates for depression were 1.2% (0.9-1.6) and 0.3% (0.3-0.4) respectively, with an adjusted csHR of 3.53 (2.56-4.85). We found similar findings for anxiety and fatigue, but risks generally diminished after 1-5 years. The use of opioids, antidepressants, and benzodiazepines increased in temporal relation to diagnosis of ITP. The risk of mental health events and the use of psychotropic drugs is higher in adult patients with ITP compared with the general population, and has a temporal relation to diagnosis of ITP emphasizing that mental health in ITP is a concern.

中文翻译：

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原发性免疫性血小板减少症成年患者的心理健康和精神药物的使用：一项全国范围的人群队列研究。

原发性免疫性血小板减少症（ITP）患者的生存率和生活质量下降，但其根本原因在很大程度上尚未被描述。 ITP 中的心理健康和精神药物的使用尚不清楚。我们利用全国登记数据，调查了成年 ITP 患者与普通人群相比，医院登记的精神健康事件（包括疲劳和使用精神药物）的风险。 1997 年至 2016 年期间，我们在丹麦卫生登记处确定了 3,749 名 ITP 患者和 149,849 名年龄性别匹配的普通人群对照者。中位年龄为 60 岁（IQR 40-73），其中 53% 为女性。我们跟踪了个人发生的心理健康事件，并估计了历年来精神药物的使用情况以及与 ITP 诊断的时间关系。患者中任何心理健康事件的第一年累积发生率为 2.3%（95% 置信区间，1.9-2.9），对照组为 0.7%（0.6-0.7），调整后的原因特异性风险比 (csHR) 为 3.57（ 2.84-4.50）。抑郁症的相应估计值分别为 1.2% (0.9-1.6) 和 0.3% (0.3-0.4)，调整后的 csHR 为 3.53 (2.56-4.85)。我们在焦虑和疲劳方面也发现了类似的结果，但风险通常会在 1-5 年后降低。阿片类药物、抗抑郁药和苯二氮卓类药物的使用随 ITP 诊断的时间增加而增加。与一般人群相比，成年 ITP 患者发生心理健康事件和使用精神药物的风险较高，并且与 ITP 的诊断存在时间关系，强调 ITP 的心理健康值得关注。