腸激躁症候群 (irritable bowel syndrome) 病患罹患憂鬱症 (depression) 時有所聞；然而， 國內的、大型的、以人口學為基礎的研究卻還沒有被報告過，因此我們想要利用台灣的全民 健康保險資料庫來探查腸激躁症候群病患後續發生憂鬱症的風險。我們設計一個世代研究， 首先由健保資料庫中確認自西元2000年至2010年新診斷腸激躁症候群的病患。每一個病患再 根據傾向分數 (propensity score) 隨機分配4 位無腸激躁症候群的參加者作為對照。研究追蹤至 2011 年底。我們使用單變項及多變項的Cox比例風險模式 (Cox proportional hazard regression model) 來評估風險比值 (hazard ratio)。研究結果發現腸激躁症候群的病患比起對照組發生憂 鬱症的比例整體高出2.30倍 ( 每千人年為12.3比5.33)，經調校後的風險比值為2.24，95%信 賴區間 (confidence interval) 為2.12 到2.36。隨著時間演進，憂鬱症的風險比值雖有減低，但 在統計學上仍有顯著意義。本研究顯示有求診之腸激躁症候群病患比起一般人具有較高的風 險罹患憂鬱症，臨床醫師應該對這群病患適時地評估並給予適當的心理支持。

The relationship between depression and irritable bowel syndrome (IBS) has been discussed. However, large scale of population-based study in Taiwan was absent. The present study attempts to determine the risk of depression in patients with IBS using data from the National Health Insurance Research Database (NHIRD). We conducted a cohort study from the National Health Insurance (NHI) system of Taiwan. Patients in the IBS cohort (n = 28,469) and the non-IBS cohort (n = 113,876) were selected by 1:4 matching based on a propensity score. The study was followed up until the end of 2011. The relative risks of depression were estimated using the Cox proportional hazard model. The results revealed the overall incidence of depression was 2.30-fold greater in the IBS cohort than in the control cohort (12.3 versus 5.33 per 1000 person-years) with an adjusted hazard ratio (HR), 2.24 (95% confidence interval = 2.12–2.36). Although the HR decreased with time, it maintained significant values for the following years. In conclusion, patients with IBS had a significantly higher risk of developing depression than the general population. Physicians should pay more attention to this group of individuals and give them appropriate support.