Department of Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
New Road Surgery, Rickmansworth, Hertfordshire, UK.
BMJ Open. 2024 Feb 28;14(2):e080408. doi: 10.1136/bmjopen-2023-080408.
To evaluate the impact of mental health comorbidity in children and young adults with inflammatory bowel disease (IBD).
Retrospective observational study.
Representative population, routinely collected primary care data from the UK Optimum Patient Care Research Database (2015-2019).
Patients with IBD aged 5-25 years with mental health conditions were compared with patients with IBD of the same age without mental health conditions.
Outcomes comprised quality-of-life indicators (low mood, self-harm, parasuicide, bowel symptoms, absence from school or work, unemployment, substance use and sleep disturbance), IBD interventions (medication, abdominal surgery, stoma formation and nutritional supplements) and healthcare utilisation (primary care interactions and hospital admissions).
Of 1943 individuals aged 5-25 years with IBD, 295 (15%) had a mental health comorbidity. Mental health comorbidity was associated with increased bowel symptoms (adjusted incident rate ratio (aIRR) 1.82; 95% CI 1.33 to 2.52), sleep disturbance (adjusted HR (aHR) 1.63; 95% CI 1.02 to 2.62), substance use (aHR 3.63; 95% CI 1.69 to 7.78), primary care interactions (aIRR 1.33; 95% CI 1.12 to 1.58) and hospital admissions (aIRR 1.87; 95%CI 1.29 to 2.75). In individuals ≥18 years old, mental health comorbidity was associated with increased time off work (aHR 1.55; 95% CI 1.21 to 1.99).
Mental health comorbidity in children and young adults with IBD is associated with poorer quality of life, higher healthcare utilisation and more time off work. It is imperative that affected young patients with IBD are monitored and receive early mental health support as part of their multidisciplinary care.
The study protocol was specified and registered a priori (ClinicalTrials.gov study identifier: NCT05206734).
评估儿童和青少年炎症性肠病 (IBD) 合并精神健康共病的影响。
回顾性观察性研究。
具有代表性的人群，来自英国 Optimum Patient Care Research Database（2015-2019 年）的常规收集的初级保健数据。
将年龄在 5-25 岁的患有 IBD 且合并精神健康状况的患者与具有相同年龄但无精神健康状况的 IBD 患者进行比较。
结局包括生活质量指标（情绪低落、自残、自杀企图、肠道症状、缺课或旷工、失业、物质使用和睡眠障碍）、IBD 干预措施（药物治疗、腹部手术、造口形成和营养补充）和医疗保健利用（初级保健互动和住院治疗）。
在 1943 名年龄在 5-25 岁的 IBD 患者中，有 295 名（15%）患有精神健康共病。精神健康共病与肠道症状增加相关（校正发病率比 (aIRR) 1.82；95%CI 1.33 至 2.52）、睡眠障碍（校正 HR (aHR) 1.63；95%CI 1.02 至 2.62）、物质使用（aHR 3.63；95%CI 1.69 至 7.78）、初级保健互动（aIRR 1.33；95%CI 1.12 至 1.58）和住院治疗（aIRR 1.87；95%CI 1.29 至 2.75）。在≥18 岁的个体中，精神健康共病与工作时间减少相关（aHR 1.55；95%CI 1.21 至 1.99）。
儿童和青少年 IBD 合并精神健康共病与生活质量下降、更高的医疗保健利用和更多的工作时间减少相关。至关重要的是，患有 IBD 的受影响年轻患者应接受监测，并作为其多学科护理的一部分获得早期精神健康支持。
该研究方案已事先具体说明并注册（ClinicalTrials.gov 研究标识符：NCT05206734）。
