Psychologic Disorders and Statin Use: A Propensity Score-Matched Analysis

Authors

  • Ishak Mansi,

    Corresponding author
    1. Uniformed Service University of Health Sciences, San Antonio, Texas
    2. University of Texas Health Science Center, San Antonio, Texas
    • Brooke Army Medical Center, San Antonio, Texas
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  • Christopher R. Frei,

    1. College of Pharmacy, University of Texas at Austin, Austin, Texas
    2. Pharmacotherapy Education and Research Center, School of Medicine, University of Texas Health Science Center, San Antonio, Texas
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  • Mary J. Pugh,

    1. South Texas Veterans Health Care System, San Antonio, Texas
    2. University of Texas Health Science Center, San Antonio, Texas
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  • Eric M. Mortensen

    1. VA North Texas Health Care System, Dallas, Texas
    2. Internal Medicine and Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
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For questions or comments, contact Ishak Mansi, Internal Medicine Service, VA North Texas Health Care System, 4500 S. Lancaster #111E; Dallas, TX 75216; e-mail: ishak.mansi@va.gov.

Abstract

Study Objective

To evaluate the association between statin therapy and the risk of psychologic disorders including schizophrenia, psychosis, major depression, and bipolar disorder in a military population.

Design

Retrospective, observational, population-based, propensity score-matched, cohort study.

Setting

Database of a patient population enrolled in the San Antonio Military Multi-Market Area as Tricare Prime or Plus.

Patients

Medical records were reviewed from 46,249 patients aged 30–85 years who were continuously enrolled in the San Antonio Military Multi-Market Area as Tricare Prime or Plus from October 1, 2003–March 1, 2010. Data were obtained from the Military Health System Management Analysis and Reporting Tool (M2). Based on drug fills during fiscal year 2005, patients were stratified as statin users (13,626 patients received at least 90-days supply of statin) or nonusers (32,623 patients never received a statin during the study period). A propensity score-matched cohort of 6972 statin users and 6972 nonusers from this population was created.

Measurements and Main Results

The occurrence of psychologic disorders between October 1, 2005, and March 1, 2010, was determined using prespecified groups of ICD-9-CM, Psych1: schizophrenia, schizoaffective disorders, and other psychosis; Psych2: major depression and bipolar disorder; Psych3: all psychologic disorders as identified by the Agency for Health Research and Quality-Clinical Classifications (except for categories of childhood or developmental psychiatric disorders). Between matched pairs of statin users and nonusers, the odds ratios and 95% confidence intervals were as follows: Psych1 (0.9, 0.75–1.05), Psych2 (1.02, 0.94–1.11), and Psych3 (1.02, 0.96–1.1), respectively.

Conclusion

The risk of developing psychologic disorders was similar in this cohort of propensity score-matched statin users and nonusers.

Ancillary