炎症性肠病患儿焦虑、抑郁和多动症的风险:一项基于人群的队列研究。

IF 3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Clinical and Translational Gastroenterology Pub Date : 2024-04-01 DOI:10.14309/ctg.0000000000000657
Rebecca Kristine Kappel, Tania Hviid Bisgaard, Gry Poulsen, Tine Jess
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引用次数: 0

摘要

引言:炎症性肠病(IBD)与成人的抑郁和焦虑有关,但关于IBD儿童患精神疾病风险的数据很少。我们旨在评估儿童发作性炎症性肠病患者患焦虑、抑郁或注意力缺陷/多动障碍的风险,得到17795个参考个体。我们使用Cox回归来计算诊断为IBD后每种结果的风险比。结果:儿童发作性IBD患者患抑郁症的风险增加(风险比[HR]1.50,95%置信区间[CI]1.26-1.80),使用抗抑郁药的风险增加,令人惊讶的是,使用哌甲酯的风险降低了(HR 0.75,95%CI 0.58-0.98)。患有两种IBD亚型(克罗恩病[CD]和溃疡性结肠炎[UC])的患者使用抗抑郁药和患抑郁症的风险增加,与背景人群相比,UC患者使用哌甲酯的风险降低(HR 0.63,95%CI 0.43-0.93),被诊断为多动症的风险降低,尽管没有统计学意义。讨论:儿科发作的IBD患者患抑郁症的风险增加了50%,这对医疗保健提供者的意识和管理很重要。值得注意的是,我们发现服用哌甲酯和被诊断为多动症的风险降低了,这值得进一步研究。
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Risk of Anxiety, Depression, and Attention-Deficit/Hyperactivity Disorder in Pediatric Patients With Inflammatory Bowel Disease: A Population-Based Cohort Study.

Introduction: Inflammatory bowel disease (IBD) is associated with depression and anxiety in adults, but data are scarce on risk of psychiatric diseases in children with IBD. We aimed to estimate the risk of anxiety, depression, or attention-deficit/hyperactivity disorder (ADHD) in patients with pediatric-onset IBD.

Methods: We performed a nationwide, register-based cohort study including all patients with pediatric-onset IBD diagnosed in Denmark during 1998-2018, resulting in 3,559 patients matched 1:5 on age, sex, municipality of residence, and time period, resulting in 17,795 reference individuals. We used Cox regression to calculate hazard ratios for each outcome after a diagnosis with IBD.

Results: Patients with pediatric-onset IBD had an increased risk of depression (hazard ratio [HR] 1.50; 95% confidence interval [CI] 1.26-1.80) and of using antidepressants (HR, 1.54; 95% CI, 1.39-1.71) and, surprisingly, a reduced risk of using methylphenidate (HR, 0.75; 95% CI, 0.58-0.98). Patients with both IBD subtypes (Crohn's disease and ulcerative colitis) had an increased risk of using antidepressants and developing depression, which was particularly high in patients with Crohn's disease (HR, 1.73; 95% CI, 1.35-2.22). Patients with ulcerative colitis had reduced risk of using methylphenidate (HR, 0.63; 95% CI, 0.43-0.93) and a reduced-although not statistically significant-risk of being diagnosed with ADHD compared with the background population.

Discussion: Patients with pediatric-onset IBD have a 50% increased risk of developing depression, which is important for healthcare providers to be aware of and manage. Remarkably, we found a reduced risk of receiving methylphenidate and being diagnosed with ADHD, which merits further investigation.

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来源期刊
Clinical and Translational Gastroenterology
Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
7.00
自引率
0.00%
发文量
114
审稿时长
16 weeks
期刊介绍: Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.
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