Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
J Dig Dis. 2021 Dec;22(12):706-713. doi: 10.1111/1751-2980.13064. Epub 2021 Nov 28.
We aimed to evaluate the incidence, predisposing factors and impacts of polysubstance use (PSU) (ie, the concurrent use or abuse of two or more drugs or substances) in inflammatory bowel disease (IBD).
Data of patients enrolled between 1 January 2015 and 31 August 2019 from a single tertiary care referral center were retrospectively collected. Patients' baseline and clinical characteristics and their antidepressant and/or anxiolytic medications were abstracted. Associations between PSU and patients' characteristics were analyzed. Multivariate logistic regression models were fit, incorporating significant clinical factors.
Altogether 315 patients with IBD (166 women, 149 men; 214 with Crohn's disease and 101 ulcerative colitis) were enrolled. Of them, 66 (21.0%) exhibited PSU (CD 21.5%, UC 19.8%); 37.5% had moderate to severe disease activity, 34.3% with extraintestinal manifestations (EIM), 41.6% with an anxious or depressed state and 69.8% had used healthcare resources in the prior 12 months. Moreover, 71.2% used two substances, while 27.3% used three substances. In the total cohort, EIM (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.14-3.34, P = 0.019) and antidepressant or anxiolytic use (OR 2.51, 95% CI 1.45-4.39, P < 0.001) were positively associated with PSU on multivariate analysis. PSU was associated with increased rate of IBD-associated imaging (57.6% vs 47.0%, P < 0.05).
PSU is common in IBD. EIM, antidepressant and/or anxiolytic use and imaging studies were independently associated with PSU. This study reinforces the importance of screening patients with IBD for substance use, particularly those with EIM and using antidepressants and/or anxiolytics.
我们旨在评估炎症性肠病（IBD）患者中多物质使用（PSU）（即同时使用或滥用两种或两种以上药物或物质）的发生率、易患因素和影响。
回顾性收集了 2015 年 1 月 1 日至 2019 年 8 月 31 日期间在一家三级转诊中心登记的患者数据。提取患者的基线和临床特征以及他们的抗抑郁药和/或抗焦虑药。分析 PSU 与患者特征之间的关系。采用多变量逻辑回归模型，纳入有意义的临床因素。
共纳入 315 例 IBD 患者（166 名女性，149 名男性；214 例克罗恩病和 101 例溃疡性结肠炎）。其中，66 例（21.0%）存在 PSU（CD21.5%，UC19.8%）；37.5%有中重度疾病活动，34.3%有肠外表现（EIM），41.6%有焦虑或抑郁状态，69.8%在过去 12 个月内使用过医疗保健资源。此外，71.2%使用两种物质，27.3%使用三种物质。在总队列中，EIM（比值比[OR]1.97，95%置信区间[CI]1.14-3.34，P=0.019）和使用抗抑郁药或抗焦虑药（OR 2.51，95%CI 1.45-4.39，P<0.001）与 PSU 呈正相关多因素分析。PSU 与 IBD 相关影像学检查的发生率增加相关（57.6%比 47.0%，P<0.05）。
PSU 在 IBD 中很常见。EIM、使用抗抑郁药和/或抗焦虑药和影像学研究与 PSU 独立相关。这项研究强调了对 IBD 患者进行物质使用筛查的重要性，特别是对有 EIM 和使用抗抑郁药和/或抗焦虑药的患者。
