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Adult-onset inflammatory bowel disease (IBD) is associated with an increased risk for psychiatric disorders and suicide attempts, according to a study published online Feb. 26 in the Journal of Crohn’s and Colitis.
Jonas F. Ludvigsson, M.D., from the Karolinska Institutet in Solna, Sweden, and colleagues assessed the risk for psychiatric morbidity and suicide in adult-onset IBD patients using data from a population-based cohort study in Sweden (1973 to 2013). The analysis included 69,865 adult-onset IBD patients (ulcerative colitis: 43,557 patients; Crohn disease [CD]: 21,245 patients; IBD-unclassified: 5,063 patients) versus 3,472,913 general population controls and 66,292 siblings.
The researchers found that during a median follow-up of 11 years, there were 10.7 percent first psychiatric disorders in IBD patients (incidence rate, 8.4 per 1,000 person-years) versus 9.9 percent in the general population (incidence rate, 6.6), resulting in 1.8 extra psychiatric morbidity per 100 patients (hazard ratio [HR], 1.3). The highest risk for overall psychiatric morbidity was seen during the first year after IBD diagnosis (HR, 1.4). Patients with extraintestinal manifestations also had a higher risk for psychiatric morbidity (HR, 1.6). All IBD types were associated with an increased risk for suicide attempts (HRs, 1.2 to 1.4), while completed suicide was particularly associated with CD (HR, 1.5) and elderly-onset IBD (diagnosed at age >60 years; HR, 1.7).
“Psychological follow-up should be provided to patients with IBD, especially those with extraintestinal manifestations and elderly-onset IBD,” the authors write. “This follow-up should transpire within the first year after IBD diagnosis.”
Several authors disclosed financial ties to the pharmaceutical industry.
HealthDay