Editorial: suicide and IBD—a call to action

Banerjee, Tyara; Gearry, Richard B.

doi:10.1111/apt.15299

Cited by 4 publications

(7 citation statements)

References 10 publications

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“…A study of Danish and Finnish paediatric IBD patients examined cancer and mortality risks and incidentally found a fourfold increased death rate due to suicide in IBD patients compared to the general population. 10,11 Patient surveys conducted in Canada and Korea have reported more than 30% increased risk of suicide in IBD patients, similar to the findings of the present study. [27][28][29] The higher incidence rates of depression and deliberate self-harm observed in the present study in patients with IBD diagnosed over the age of 50 are consistent with a recent study from Sweden, which highlighted higher rates of suicide in individuals with late-onset IBD and Crohn's disease.…”

Section: Ta B L Esupporting

confidence: 91%

“…7,8 Finally, IBD is associated with an increased risk of self-harm, especially among patients diagnosed with IBD in childhood. [9][10][11] A recent study in Denmark and Finland reported that deliberate self-harm was a leading cause of mortality among IBD patients. 11 However, factors associated with deliberate self-harm in patients with IBD have not been previously described.…”

Section: Introductionmentioning

confidence: 99%

“…Disordered sleep or insomnia has also been reported to be associated with IBD, and significantly affect the quality of life of patients with IBD 7,8 . Finally, IBD is associated with an increased risk of self‐harm, especially among patients diagnosed with IBD in childhood 9‐11 . A recent study in Denmark and Finland reported that deliberate self‐harm was a leading cause of mortality among IBD patients 11 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The association between inflammatory bowel disease and mental ill health: a retrospective cohort study using data from UK primary care

Umar

King

Chandan

et al. 2022

Aliment Pharmacol Ther

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Summary Background Patients with active inflammatory bowel disease (IBD) and mental illnesses experience worse IBD outcomes. Aim To describe the incidence of mental illnesses, including deliberate self‐harm, in IBD patients. Methods A population‐based retrospective cohort study using IQVIA medical research data of a primary care database covering the whole UK, between January 1995 and January 2021. IBD patients of all ages were matched 4:1 by demographics and primary care practice to unexposed controls. Following exclusion of patients with mental ill health at study entry, adjusted hazard ratios (HR) of developing depression, anxiety, deliberate self‐harm, severe mental illness and insomnia were calculated using a Cox proportional hazards model. Results We included 48,799 incident IBD patients: 28,352 with ulcerative colitis and 20,447 with Crohn's disease. Incidence rate ratios of mental illness were higher in IBD patients than controls (all p < 0.001): deliberate self‐harm 1.31 (95% CI 1.16–1.47), anxiety 1.17 (1.11–1.24), depression 1.36 (1.31–1.42) and insomnia 1.62 (1.54–1.69). Patients with Crohn's disease were more likely to develop deliberate self‐harm HR 1.51 (95% CI 1.28–1.78), anxiety 1.38 (1.16–1.65), depression 1.36 (1.26–1.47) and insomnia 1.74 (1.62–1.86). Patients with IBD are at increased risk of deliberate self‐harm (HR 1.20 [1.07–1.35]). The incidence rate ratios of mental illnesses were particularly high during the first year following IBD diagnosis: anxiety 1.28 (1.13–1.46), depression 1.62 (1.48–1.77) and insomnia 1.99 (1.78–2.21). Conclusion Deliberate self‐harm, depression, anxiety and insomnia were more frequent among patients with IBD. IBD is independently associated with an increased risk of deliberate self‐harm.

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Section: Ta B L Esupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The association between inflammatory bowel disease and mental ill health: a retrospective cohort study using data from UK primary care

Umar

King

Chandan

et al. 2022

Aliment Pharmacol Ther

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“…As stated in the editorial by Drs Banerjee and Gearry, the main result of the present study is the finding of an increased risk of cancer and mortality in pIBD with a surprisingly high risk of suicide. In contrast to the adult literature on this subject, the paediatric literature almost unambiguously reports an increased risk of cancer in pIBD and the main question is no longer if there's an increased risk but why.…”

supporting

confidence: 55%

Editorial: suicide and IBD—a call to action. Authors’ reply

Malham

Jakobsen

Hald

et al. 2019

Aliment Pharmacol Ther

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“…However, to our knowledge, no studies have investigated whether differences in disease course between pUC and aUC could be explained by differences in the initial disease extent. Lastly, recent reports have found an increased risk of cancer in pIBD, possibly due to a more extensive and aggressive disease state compared to aIBD …”

Section: Introductionmentioning

confidence: 92%

Paediatric onset inflammatory bowel disease is a distinct and aggressive phenotype—a comparative population‐based study

et al. 2019

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Background: Paediatric onset IBD (pIBD) has been reported to be more aggressive than adult onset IBD (aIBD). Yet, a more extensive disease presentation in paediatric onset ulcerative colitis (pUC) has been the only consistent finding. Aims:In a population-based study, we aimed to further elucidate the differences in disease course between pIBD and aIBD. Methods:We compared a pIBD cohort (diagnosis <15 years of age) and an aIBD cohort (diagnosis ≥18 years of age). Medical records were retrieved manually at last follow-up, and clinical data concerning IBD phenotype and treatment were registered. Results:We included 333 pIBD and 449 aIBD patients. Patients with pIBD more often presented with extensive disease localisation than aIBD (24%/9% of pCD/aCD with L4 disease localisation and 67%/24% of pUC/aUC with E3 disease extent). Of the patients with inflammatory disease at diagnosis, 34% and 16% of pCD and aCD patients, respectively, progressed to complicated disease over the first 7 years after diagnosis (P = .002). Patients with pUC were more often treated with systemic corticosteroids (HR: 2.0 [CI: 1.6-2.6], P < .0001) and/or thiopurines (HR: 3.8 [CI: 2.8-5.2], P < .0001). Lastly, pIBD patients more often received biologics (HR: 2.5 [CI: 1.8-3.6, P < .0001] in CD and HR: 3.8 [CI: 2.1-6.9, P < .0001] in UC) and had an increased risk of relapse (incidence rate ratio of 1.8 [CI: 1.4-2.2, P < .0001]). Conclusions:In this population-based cohort study we demonstrated a more severe disease course in pIBD than in aIBD. This message should be considered by both paediatric and adult gastroenterologists when caring for pIBD patients.

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Editorial: suicide and IBD—a call to action

Abstract: Linked ContentThis article is linked to Malham et al papers. To view these articles, visit https://doi.org/10.1111/apt.15258 and https://doi.org/10.1111/apt.15318.

Cited by 4 publications

References 10 publications

The association between inflammatory bowel disease and mental ill health: a retrospective cohort study using data from UK primary care

The association between inflammatory bowel disease and mental ill health: a retrospective cohort study using data from UK primary care

Editorial: suicide and IBD—a call to action. Authors’ reply

Paediatric onset inflammatory bowel disease is a distinct and aggressive phenotype—a comparative population‐based study

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