Childhood IBD tied to excess risk for psychiatric disorders, suicide attempt

  • JAMA Pediatr

  • von Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Children diagnosed with inflammatory bowel disease (IBD) were significantly more likely to attempt suicide or develop a psychiatric disorder compared with children without IBD.
  • Risk was especially high for ADHD, autism, mood, anxiety, eating, or personality disorders.

Why this matters

  • Overall risk was highest in first year of follow-up, but remained significant for >5 years.
  • Results were validated by sibling comparison.

Study design

  • Population-based cohort study (childhood-onset IBD; n=6464; matched reference, n=323,200).
  • Median follow-up: 9 years.
  • Funding: The Swedish Cancer Society; others.

Key results

  • The IBD group was diagnosed with:
    • ulcerative colitis (n=3228),
    • Crohn's disease (n=2536), or
    • unclassified IBD (n=700).
  • The IBD group (vs reference) was at increased risk for:
    • any psychiatric disorder (HR, 1.6; 95% CI, 1.5-1.7),
    • suicide attempts (HR, 1.4; 95% CI, 1.2-1.7),
    • mood disorders (HR, 1.6; 95% CI, 1.4-1.7),
    • anxiety disorders (HR, 1.9; 95% CI, 1.7-2.0),
    • eating disorders (HR, 1.6; 95% CI, 1.3-2.0),
    • personality disorders (HR, 1.4; 95% CI, 1.1-1.8),
    • ADHD (HR, 1.2; 95% CI, 1.1-1.4), and
    • autism spectrum disorders (HR, 1.4; 95% CI, 1.1-1.7).

Limitations

  • No direct measurements for IBD severity.
  • Severity of IBD may be associated with psychiatric disorders.

Coauthored with Chitra Ravi, MPharm