Incidence of Suicide in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Abstract

Background and Aims Patients with inflammatory bowel disease (IBD) have higher incidence of psychosocial disorders, including depression. As suicide is the most severe manifestation of depression, we sought to identify if patients with IBD have a higher incidence of suicide through a systematic review and meta-analysis. Methods Systematic literature searches for articles using EMBASE and MEDLINE using Ovid were conducted to identify studies investigating suicide in IBD. Reference harvesting of the bibliographies of key articles was also performed. We included studies reporting expected number of death or standardized mortality ratio (SMR) for suicide in IBD. Meta-analysis for each IBD condition (Crohn’s disease [CD] and ulcerative colitis [UC]) was conducted separately, as well as combined. Results Seven cohort studies were identified through our search strategy and included in our systematic review and meta-analysis. In our analysis, the SMR for suicide in patients with IBD for all studies included was 1.20 (95% CI, 0.94–1.54). The overall pooled SMR for CD and UC were 1.36 (95% CI, 0.98–1.88) and 1.16 (95% CI, 0.8–1.69) respectively. Conclusions Patients with Crohn’s disease and ulcerative colitis may have an increased risk of suicide. These results highlight the importance physicians must place on ensuring the mental health of patients with IBD is both assessed and treated appropriately.

Psychological distress is highly prevalent in inflammatory bowel disease: A survey of psychological needs and attitudes

“…17 Psychological care in IBD (Australian IBD Standard A13) Level of distress. The mean level of distress for these respondents (K10 = 20.9) was within the mild distress category (20)(21)(22)(23)(24), while 51% of respondents reported good mental health (K10 score < 20), and 15% reported severe distress (K10 score ≥ 30) ( Table 1).…”

“…Of note, while good‐quality data on suicide in IBD in Australia are not available, a large‐scale American study ( n = 2 325 226) showed that 27% of people with IBD and depression reported suicidal ideation versus 12% of those without depression . A recent meta‐analysis indicated that people with IBD may have increased risk of suicide . Psychological screening is an Australian standard of care for all people with IBD .…”

“…21 A recent meta-analysis indicated that people with IBD may have increased risk of suicide. 22 Psychological screening is an Australian standard of care for all people with IBD. 12 Asking about mental health when a patient seeks help for IBD is an opportunity to identify and address distress.…”

Depresszív tüneteket és öngyilkossági gondolatokat befolyásoló tényezők gyulladásos bélbetegségben szenvedők körében

“…Az öngyilkossági rizikó IBD-s fiatalok körében a három leggyakoribb, mortalitást jelentő ok között szerepel egy skandináv vizsgálat szerint [24]. A Zhang és mtsai által publikált metaanalízis alapján a IBD-vel élők körében magasabb öngyilkossági rizikó feltételezhető az átlagnépességhez képest [25].…”

Addressing Mental Health in Persons with IBD

“…In this issue of JCAG, a systematic review and meta-analysis of suicide in IBD is reported (13). The analysis was mostly negative.…”