COPENHAGEN — Children and young adults with inflammatory bowel disease (IBD) are about 2.5 times more likely to develop post-traumatic stress disorder (PTSD), nearly twice as likely to report an eating disorder, and 1.5 times more likely to report self harm suggests a new UK study.
The retrospective observational study of young people with IBD versus those without it assessed the incidence of a wide range of mental health conditions in people aged 5 to 25 years.
“Anxiety and depression will not be a surprise to most of us. But we also saw changes in eating disorders, PTSD and changes in sleep,” said Richard K. Russell, MD, a pediatric gastroenterologist at the Royal Hospital for Sick Children in Edinburgh, Scotland.
Russell presented the research at the European Crohn’s and Colitis Organization (ECCO) Congress 2023, held virtually in Copenhagen, Denmark.
Our findings indicate an unmet need for mental health care for young IBD patients, he said. “All of us at ECCO need to address this gap.”
key results
Russell and colleagues identified 3,898 youth diagnosed with IBD in the 10-year period of January 1, 2010, to January 1, 2020 using Optimum’s patient care research database, which includes de-identified data from more than 1000 general practices across the UK. They used propensity score matching to create a control group of 15,571 people without IBD, controlling for age, sex, socioeconomic status, ethnicity, and health conditions other than IBD.
The median follow-up was about 3 years.
The cumulative lifetime risk of developing any mental health condition at age 25 was 31.1% in the IBD group versus 25.1% in controls, a statistically significant difference.
Compared to the control group, people with incident IBD were significantly more likely to develop:
The majority are men at risk included in general, and specifically boys from 12 to 17 years of age. People with Crohn’s disease versus other types of IBD were also at higher risk.
In a subgroup analysis, presented as a poster at the meeting, Russell and colleagues also found that mental health comorbidity in children and young adults with IBD is associated with increased IBD symptoms and health care utilization. , as well as free time at work.
Children and young adults with IBD and mental health problems should be monitored and receive appropriate mental health support as part of their multidisciplinary care, Russell said.
Russell added that the study period ended a few months before the COVID-19 pandemic began, so the research does not reflect its impact on the mental health of the study population.
“The number of children and young adults that we are seeing in our clinic with mental health issues has gone through the roof because of the pandemic,” he said.
Russell suggested that the organization create a psychology subgroup called ECCO Proactive Psychologists, or Prosecco for short.
clinical implications
The study is important in highlighting the increased burden of mental health problems in young people with IBD, said session co-chair Nick Kennedy, MD, a consultant gastroenterologist and director of research information at the Royal Devon University Healthcare NHS Foundation Trust. in the United Kingdom.
Kennedy, who was not affiliated with the research, also supports the idea of a psychological subgroup within ECCO.
The peak age for developing mental health disorders that the study found (12 to 17 years) “is a unique and very sensitive time,” said Sara Mesilhy, MBBS, a gastroenterologist at the Royal College of Physicians in the United Kingdom.
“These results highlight the need to develop early detection psychiatric programs that start from the time of diagnosis and continue at regular intervals to offer the best management plan for IBD patients, especially those with childhood-onset IBD,” he said. Mesilhy, who was not affiliated with the investigation.
Such programs “would improve the quality of life of the patient, protecting them from a lot of suffering and preventing the bad sequelae of these disorders,” Mesilhy said. “In addition, we still need more studies to identify the most efficient monitoring and treatment protocols.”
Kennedy applauded the researchers for conducting a population-based study because it ensured an adequate cohort size and maximized the identification of mental health disorders.
“It was interesting to see that there were a variety of conditions in which the risk was increased, and that men with IBD were at particularly increased risk,” he added.
The researchers’ use of coded primary care data was a limitation of the study, but “this was adequately acknowledged by the presenter,” Kennedy said.
The study was supported by Pfizer. Russell revealed that he is a consultant and a member of a Pfizer speakers bureau outside of the featured work. Kennedy and Mesilhy do not report any relevant financial conflicts of interest.
Congress of the European Organization for Crohn’s Disease and Colitis (ECCO) 2023: Abstract OP28 and Poster P822. Submitted on March 3, 2023.
Damien McNamara is a staff Miami-based journalist. She covers a wide range of medical specialties, including infectious diseases, gastroenterology, and critical care. Follow Damien on Twitter: @MedReportero.
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