Prevalence of depression and anxiety in people with inflammatory bowel disease and associated healthcare use: population-based cohort study.

IF 6.6 2区医学 Q1 PSYCHIATRY Evidence Based Mental Health Pub Date : 2021-03-30 DOI:10.1136/ebmental-2020-300223

Peter Irving, Kevin Barrett, Monica Nijher, Simon de Lusignan

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Abstract

Background: Inflammatory bowel disease (IBD) has a significant impact on quality of life for many people.

Objective: To assess the prevalence of common mental health conditions in IBD and the combined impact of IBD and mental health conditions on healthcare use and time off work.

Methods: A UK population-based primary care database (Royal College of General Practitioners Research and Surveillance Centre) was used to identify adults with IBD (n=19 011) (Crohn's disease (CD) or ulcerative colitis (UC)), and matched controls (n=76 044). Prevalences of anxiety, depressive episodes and depressive disorder recorded in primary care were assessed between 2016 and 2018. Outcomes comprised of rates of primary care visits, emergency secondary care visits, certificates for time off work, antidepressant and anxiolytic prescriptions.

Findings: Mental health conditions were more common in people with CD than controls: anxiety episodes (3.5% vs 3.0%; p=0.02), depressive episodes (5.7% vs 4.1%; p<0.001) and depressive disorder (17.5% vs 12.9%; p<0.001), and people with UC versus controls: depressive episodes (4.4% vs 3.6%; p<0.001) and depressive disorder (14.2% vs 12.4%; p<0.001). Healthcare utilisation rates were higher in people with IBD than controls (primary care visits incidence rate ratio 1.47 (95% CI 1.43 to 1.51); emergency secondary care visits 1.87 (1.79 to 1.95); fitness for work certificates 1.53 (1.44 to 1.62); antidepressant use 1.22 (1.13 to 1.32); anxiolytic use 1.20 (1.01 to 1.41)). In people with IBD, mental health conditions were associated with additional increases in healthcare use and time off work.

Conclusion: Depression and anxiety are more common in people with IBD than matched controls. Healthcare utilisation and prescribing of psychotropic medications are also higher in people with IBD. Mental health conditions in people with IBD are associated with additional healthcare use and time off work.

Clinical implications: Evidence-based mental health support programmes, including psychological treatments, are needed for people with IBD.

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炎症性肠病患者抑郁和焦虑的患病率及相关医疗服务的使用：基于人群的队列研究。

背景：炎症性肠病（IBD）对许多人的生活质量造成严重影响：炎症性肠病（IBD）对许多人的生活质量有重大影响：目的：评估 IBD 常见精神健康状况的患病率，以及 IBD 和精神健康状况对医疗保健使用和请假时间的综合影响：方法：使用英国基于人口的初级保健数据库（皇家全科医师学院研究与监测中心）来识别患有 IBD（克罗恩病 (CD) 或溃疡性结肠炎 (UC)）的成人（n=19 011）和匹配的对照组（n=76 044）。对2016年至2018年期间初级保健中记录的焦虑、抑郁发作和抑郁障碍的患病率进行了评估。结果包括初级保健就诊率、二级保健急诊就诊率、请假证明、抗抑郁药和抗焦虑药处方：与对照组相比，CD患者的精神健康状况更为常见：焦虑发作（3.5% vs 3.0%；P=0.02）、抑郁发作（5.7% vs 4.1%；P=0.02）：与匹配的对照组相比，抑郁和焦虑在 IBD 患者中更为常见。IBD 患者的医疗保健使用率和精神药物处方量也更高。IBD患者的精神健康状况与额外的医疗保健使用和请假时间有关：临床意义：IBD 患者需要基于证据的心理健康支持计划，包括心理治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Evidence Based Mental Health PSYCHIATRY-

CiteScore

18.10

自引率

7.70%

发文量

期刊介绍： Evidence-Based Mental Health alerts clinicians to important advances in treatment, diagnosis, aetiology, prognosis, continuing education, economic evaluation and qualitative research in mental health. Published by the British Psychological Society, the Royal College of Psychiatrists and the BMJ Publishing Group the journal surveys a wide range of international medical journals applying strict criteria for the quality and validity of research. Clinicians assess the relevance of the best studies and the key details of these essential studies are presented in a succinct, informative abstract with an expert commentary on its clinical application.Evidence-Based Mental Health is a multidisciplinary, quarterly publication.