Cooney Rachel, Tang Daniel, Barrett Kevin, Russell Richard K
GI Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Pfizer Ltd, Tadworth, United Kingdom.
Inflamm Bowel Dis. 2024 Aug 1;30(8):1264-1273. doi: 10.1093/ibd/izad169.
The burden of mental health conditions in children and young adults with inflammatory bowel disease remains unclear. We assessed this using a primary care database in the United Kingdom.
A retrospective, observational study compared children and young adults with incident inflammatory bowel disease 5 to 25 years of age (2010-2020) against population control subjects. Outcomes comprised incident depression, anxiety disorder, eating disorders, body image disorders, attention-deficit disorders, behavioral disorders, adjustment disorders, acute stress disorder, schizophrenia, bipolar disorder, posttraumatic stress disorder, self-harm, parasuicide (including suicide), and sleep disturbance. The any mental health condition category comprised any of these conditions.
A total of 3898 young patients with incident inflammatory bowel disease were matched to 15 571 control subjects. Inflammatory bowel disease patients were significantly more likely to develop new posttraumatic stress disorder (adjusted hazard ratio [aHR], 2.47; 95% confidence interval [CI], 1.23-4.94), eating disorders (aHR, 1.85; 95% CI, 1.05-3.26), self-harm (aHR, 1.49; 95% CI, 1.00-2.21), sleep disturbance (aHR, 1.40; 95% CI, 1.15-1.71), depression (aHR, 1.34; 95% CI, 1.16- 1.56), anxiety (aHR, 1.25; 95% CI, 1.06-1.48), and any mental health condition (aHR, 1.28; 95% CI, 1.12-1.46). Male inflammatory bowel disease patients aged 12 to 17 years, and patients with Crohn's disease appear to have the highest risk for developing new mental health conditions.
Young inflammatory bowel disease patients have a significantly higher incidence and risk of new mental health conditions. Mental health remains a critically overlooked aspect of inflammatory bowel disease patient management. Further research into identifying optimal monitoring tools and support for these patients is required to improve patient care. The study protocol was specified and registered a priori.ClinicalTrials.gov study identifier: NCT05206734.
炎症性肠病患儿和青年心理健康问题的负担仍不明确。我们利用英国的一个初级保健数据库对此进行了评估。
一项回顾性观察性研究将2010年至2020年期间5至25岁的新发炎症性肠病患儿和青年与人群对照受试者进行了比较。结局包括新发抑郁症、焦虑症、饮食失调、身体形象障碍、注意力缺陷障碍、行为障碍、适应障碍、急性应激障碍、精神分裂症、双相情感障碍、创伤后应激障碍、自我伤害、准自杀（包括自杀）和睡眠障碍。任何心理健康状况类别包括上述任何一种情况。
共有3898例新发炎症性肠病的年轻患者与15571名对照受试者进行了匹配。炎症性肠病患者发生新发创伤后应激障碍（调整后风险比[aHR]，2.47；95%置信区间[CI]，1.23 - 4.94）、饮食失调（aHR，1.85；95% CI，1.05 - 3.26）、自我伤害（aHR，1.49；95% CI，1.00 - 2.21）、睡眠障碍（aHR，1.40；95% CI，1.15 - 1.71）、抑郁症（aHR，1.34；95% CI，1.16 - 1.56）、焦虑症（aHR，1.25；95% CI，1.06 - 1.48）以及任何心理健康状况（aHR，1.28；95% CI，1.12 - 1.46）的可能性显著更高。12至17岁的男性炎症性肠病患者以及克罗恩病患者似乎发生新发心理健康问题的风险最高。
年轻的炎症性肠病患者新发心理健康问题的发生率和风险显著更高。心理健康仍然是炎症性肠病患者管理中一个严重被忽视的方面。需要进一步研究确定针对这些患者的最佳监测工具并提供支持，以改善患者护理。研究方案已事先指定并注册。ClinicalTrials.gov研究标识符：NCT05206734。
