Young Patients With IBD at Increased Risk for New-Onset Mental Health Disorders

Children and young adults diagnosed with inflammatory bowel disease (IBD) have a greater incidence and risk of developing new-onset mental health disorders, according to study findings in Inflammatory Bowel Diseases.

Patients diagnosed with IBD in childhood and young adulthood face unique psychosocial challenges in managing the disease. 

Researchers conducted a study (ClinicalTrials.gov Identifier: NCT05206734) to determine the incidence and risk of mental health conditions among children and young adults with IBD prior to the COVID-19 pandemic.

Data was taken from the United Kingdom’s Optimum Patient Care Research Database (OPCRD). Children and young adults diagnosed with IBD between 2010 and 2019 were included in the study. All 3 types of IBD were considered for inclusion: ulcerative colitis (UC), Crohn disease, and IBD unclassified (IBDU).

A total of 3898 participants met the inclusion criteria and were matched to 15,571 control group participants. Of these participants, 299 (8.7%) of 3423 patients with IBD and (6.6%) of 12,256 control group patients were diagnosed with at least 1 new-onset mental health condition. 

The most common new-onset mental health conditions diagnosed in patients with vs without IBD were depression (6.5% vs 4.7%), anxiety disorder (5.1% vs 3.9%), and sleep disturbance (3.9% vs 2.6%).

Among the IBD cohort, there were 82 participants with both depression and anxiety, 5 participants with depression and an eating disorder, and 4 participants with attention-deficit disorder and behavioral and conduct disorder. 

Participants with IBD were more likely to be diagnosed with new-onset mental health disorders, compared with the control group. Post-traumatic stress disorder (adjusted hazard ratio [aHR], 2.47; 95% CI, 1.23-4.94), eating disorders (aHR, 1.85; 95% CI, 1.05-3.26), and self-harm (aHR, 1.49; 95% CI, 1.00-2.21) developed at a significantly higher risk in the IBD cohort. 

The researchers also found significantly increased risks of developing sleep disturbances (aHR, 1.40; 95% CI, 1.15-1.71), depression (aHR, 1.34; 95% CI, 1.16-1.56), and anxiety (aHR, 1.25; 95% CI, 1.06-1.48) among participants with IBD, compared with the control group. 

Overall, participants with IBD were at an increased risk of developing any mental health condition (aHR, 1.28; 95% CI, 1.12-1.46), compared with participants without IBD. 

The subgroup analysis revealed that male participants with IBD had an increased risk of developing a mental health disorder (aHR, 1.43; 95% CI, 1.17-1.75), but female participants did not (aHR, 1.18; 95% CI, 0.99-1.40). 

Participants who were aged 12 to 17 years (aHR, 1.39; 95% CI, 1.14-1.70) were reported to have the highest incidence of newly diagnosed mental health conditions, compared with participants who were aged 5 to 11 years and 18 to 25 years. 

In addition, participants with CD had an increased risk for new-onset depression (aHR, 1.41; 95% CI, 1.15-1.74; P =.001) and anxiety (aHR, 1.39; 95% CI, 1.11-1.74; P =.004), compared with the control group. There were no significant associations observed for patients with UC. 

“This study found a higher incidence of depression, anxiety, sleep disturbance, self-harm, and eating disorders among young IBD patients compared with control subjects,” study authors wrote. “More notably, these patients have a significantly higher risk for developing PTSD, eating disorders, self-harm, sleep disturbance, and depression when compared with control subjects. Male and IBD patients 12 to 17 years of age appear to have the highest risk for developing new mental health conditions.”

Study limitations include the inability to establish causality, lack of data availability, and underpowered data. 

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of the author’s disclosures.

This article originally appeared on Gastroenterology Advisor