Ma Simeng, Wang Wei, Gong Qian, Xiang Dan, Yao Lihua, Xu Shuxian, Xie Xinhui, Wang Huiling, Wang Gaohua, Yang Jun, Liu Zhongchun
Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
School of Information Engineering, Wuhan University of Technology, Wuhan, China.
Gen Hosp Psychiatry. 2023 May-Jun;82:26-32. doi: 10.1016/j.genhosppsych.2023.03.002. Epub 2023 Mar 12.
Depression is more common in patients with chronic inflammatory diseases, but whether inflammatory bowel disease (IBD), a chronic, relapsing immune-mediated disease, is associated with a higher risk of depression remains uncertain.
We studied 497,134 participants in the UK Biobank, including 3561 IBD patients. Multivariate Cox proportional risk models were constructed to investigate the risk associated with IBD and depression adjusting for potential confounding factors including sociodemographic, lifestyle, and family history variables.
The average age of participants was 56.54 ± 8.09 years; 54.3% were female and 90.4% were white. Over a mean follow-up period of 13.3 years, the cumulative incidence of depression was 8.2% (95% CI: 7.3%-9.1%) in IBD patients compared with 4.9% (95% CI: 4.9%-5.0%) in individuals without IBD. Compared with non-IBD participants, the adjusted hazard ratio (HR) for depression among IBD patients was 1.56 (95% CI: 1.39-1.76), with an adjusted HR of 1.54 (95% CI: 1.25-1.90) in Crohn's disease and 1.52 (95% CI: 1.30-1.78) in ulcerative colitis, respectively.
IBD patients had a significantly higher risk of depression than non-IBD participants after adjusting for multiple confounding factors. We recommend screening for depression in middle-aged adults with IBD and no established history of depression.
抑郁症在慢性炎症性疾病患者中更为常见，但作为一种慢性复发性免疫介导疾病的炎症性肠病（IBD）是否与更高的抑郁症风险相关仍不确定。
我们研究了英国生物银行中的497134名参与者，其中包括3561名IBD患者。构建多变量Cox比例风险模型，以研究在调整包括社会人口统计学、生活方式和家族史变量等潜在混杂因素后，IBD与抑郁症相关的风险。
参与者的平均年龄为56.54±8.09岁；54.3%为女性，90.4%为白人。在平均13.3年的随访期内，IBD患者中抑郁症的累积发病率为8.2%（95%CI：7.3%-9.1%），而无IBD的个体中为4.9%（95%CI：4.9%-5.0%）。与非IBD参与者相比，IBD患者中抑郁症的调整后风险比（HR）为1.56（95%CI：1.39-1.76），克罗恩病患者的调整后HR为1.54（95%CI：1.25-1.90），溃疡性结肠炎患者的调整后HR为1.52（95%CI：1.30-1.78）。
在调整多个混杂因素后，IBD患者患抑郁症的风险显著高于非IBD参与者。我们建议对无抑郁症既往史的中年IBD成年人进行抑郁症筛查。
