咖啡與憂鬱症之探討

Abstract

世界衛生組織所統計的全球高負擔疾病中，憂鬱排名第三名，並預測在2030年將攀升至第一名。憂鬱症在台灣一年所造成的社會經濟損失，已逾350億元新台幣。根據文獻回顧及統合分析文獻的結果，認為咖啡攝取是與憂鬱症有顯著負相關性的，顯示咖啡暴露可能可降低憂鬱症發生的風險。 本研究為一橫斷式研究，利用2005-2015年臺灣北部社區整合式篩檢世代，共納入86,075位20歲以上之個案進行分析，問卷資料中咖啡及茶的暴露頻率為主要變項，連結個案憂鬱症及重鬱症之ICD診斷碼，探討咖啡與茶暴露量與憂鬱症/重鬱症之相關，主要分析以羅吉斯迴歸分析為主，呈現單變項咖啡或茶對於憂鬱症/重鬱症之勝算比，以及考慮其他可能干擾因子之多變項分析。 本研究發現咖啡與憂鬱症是有顯著負相關性的，每周喝5-6次與憂鬱症有最大負相關性，相較於每周喝少於1次之族群有32% (95%信賴區間: 22%-40%) 較低之憂鬱症風險有顯著相關性，並且有明顯劑量效應；另外此研究也同樣發現茶之攝取量與憂鬱症也是呈現負相關的，並且也是以每周喝5-6杯為與憂鬱症有最大負相關性，相較於每周喝少於1次之族群有37% (95%信賴區間: 29%-43%) 較低之憂鬱症風險有顯著相關性。而在咖啡與重度憂鬱症之關係，發現咖啡與重度憂鬱症之關係仍僅於每周喝1-2次咖啡的人有顯著負相關性，相較於每周喝少於1次之族群有38% (95%信賴區間: 4%-60%) 較低之憂鬱症風險有顯著相關性，其他咖啡攝取之組別則與重度憂鬱症之相關性不具統計上顯著性；而茶與重度憂鬱症雖呈現負相關性，但皆不具統計顯著性。 總結本研究分析，考慮其他憂鬱症相關影響因子後，咖啡可能為憂鬱症之顯著保護因子之一。

Among the global burden of diseases calculated by the World Health Organization(WHO), depression ranks third, and it is predicted that it will climb to the first place in 2030. The annual socio-economic loss due to depression in Taiwan has exceeded NT$35 billion.。 This study is a cross-sectional study, using the data from community-based integrated screening in northern Taiwan’s communities from 2005 to 2015, including 86,075 cases over the age of 20. The frequency of coffee and tea exposure in the questionnaire is the main variable. We link the ICD diagnosis codes of cases for depression and major depressive disorder, and explore the relationship between coffee or tea exposure and depression/ major depressive disorder. The main analysis is based on Logis regression model analysis, and the protective effective for depression/major depressive disorder is shown by odds ratio (OR). The adjusted ORs of depression/major depressive disorder are presented in multivariate analysis considering other potential confounding factors. According to the results of literature review and meta-analysis, it is believed that coffee intake is significantly inversely correlated with depression. Our study consistently found a significantly negatively relationship between coffee and depression. Coffee intake 5-6 times per week is the most protective category for reducing the risk of depression compared to less than 1 times per week by 32% (95% CI: 22%-40%). In addition, we also found there’s an inverse association between tea and depression, with 5-6 times per week being the most protective effect compared to less than 1 times per week by 37% (95%CI: 29%-43%). As for the relationship between coffee and major depressive disorder, it is found that the relationship between coffee and major depressive disorder is only significantly negatively correlated with people who drink coffee 1-2 times per week, compared to those who drink less than once a week by 38% (95%CI: 4%-60%). Other coffee intake groups have no statistically significant correlation with major depressive disorder. We also found there’s a negative correlation between tea and major depressive disorder, however they are not statistically significant. In conclusion, this study indicates that coffee may be a significant protective factor for depression after considering other potential confounding factors.