Pediatr Gastroenterol Hepatol Nutr.  2019 Nov;22(6):527-535. 10.5223/pghn.2019.22.6.527.

Burden of Psychiatric Disorders among Pediatric and Young Adults with Inflammatory Bowel Disease: A Population-Based Analysis

• Thavamani
• Umapathi K
• Khatana J
• Gulati R

• KMID: 2462092
• DOI: http://doi.org/10.5223/pghn.2019.22.6.527

Abstract

PURPOSE
There is increasing prevalence of psychiatric disorders among inflammatory bowel Disease (IBD) population. Further, presence of psychiatric disorders has been shown as an independent predictor of quality of life among patients with IBD. We intended to explore the prevalence of various psychiatric disorders among pediatric and young adult population with IBD as a population-based analysis.
METHODS
We did a retrospective case control analysis using a deidentified cloud-based database including health care data across 26 health care networks comprising of more than 360 hospitals across USA. Data collected across different hospitals were classified and stored according to Systematized Nomenclature of Medicine-Clinical Terms. We preidentified 10 psychiatric disorders and the queried the database for the presence of at least one of the ten psychiatric disorders among IBD patients between 5 and 24 years of age and compared with controls.
RESULTS
Total of 11,316,450 patients in the age group between 5 and 24 years and the number of patients with a diagnosis of IBD, Crohn's disease or ulcerative colitis were 58,020. The prevalence of psychiatric disorders was 21.6% among IBD mainly comprising of depression and anxiety disorder. Multiple logistic regression analysis showed, IBD is 5 times more likely associated with psychiatric disorders than controls, p<0.001). We showed a steady increasing trend in the incidence of psychiatric disorders among IBD patients (2% in 2006 to 15% in 2017).
CONCLUSION
Largest population-based analysis demonstrated an increased prevalence of psychiatric disorders among IBD patients. Our study emphasizes the need for psychological and mental health services to be incorporated as a part of the routine IBD clinic.

Keyword

Inflammatory bowel disease; Ulcerative colitis; Crohn's disease; Psychiatric disorder; Mental health disorder; Depression; Anxiety; Adjustment disorder; Population based analysis; Prevalence

MeSH Terms

Adjustment Disorders
Anxiety
Anxiety Disorders
Case-Control Studies
Colitis, Ulcerative
Crohn Disease
Delivery of Health Care
Depression
Diagnosis
Humans
Incidence
Inflammatory Bowel Diseases*
Logistic Models
Mental Health Services
Prevalence
Quality of Life
Retrospective Studies
Young Adult*

Figure

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  Fig. 1 Association of various psychiatric disorders with inflammatory bowel disease. BPD: bipolar disorder, PTSD: post traumatic stress disorder, MDD: major depressive disorder.

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  Fig. 2 Relative proportion of depression, anxiety and adjustment disorder among inflammatory bowel disease patients with psychiatric disorder.

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  Fig. 3 (A) Incidence trend of psychiatric disorders among inflammatory bowel disease (IBD) patients between years 2006 and 2017. (B) Incidence trend of anxiety, depression and adjustment disorder among IBD patients. MHD: mental health disorder.

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