Risk of Anxiety and Depression in Patients with Inflammatory Bowel Disease: A Nationwide, Population-Based Study
Risk of Anxiety and Depression in Patients with Inflammatory Bowel Disease: A Nationwide, Population-Based Study
复制标题
DOI：
10.3390/jcm8050654
复制
发表时间：
2019-05-01
影响因子：
3.9
通讯作者：
Kim, Joo Sung
中科院分区：
文献类型：
--
作者：
Choi, Kookhwan;Chun, Jaeyoung;Kim, Joo Sung
背景和目的：炎症性肠病(IBD)可能与焦虑和抑郁有关。这项研究的目的是评估IBD患者与普通人群相比焦虑和抑郁的发生率。方法：使用韩国国家医疗保险服务机构的索赔数据，进行了一项基于全国人群的队列研究。我们比较了15,569名IBD患者和46,707名非IBD对照组的焦虑和抑郁的发生率，年龄和性别按1：3匹配。结果：在平均6年的随访中，IBD患者比对照组经历了明显更多的焦虑(12.2%比8.7%；p<；0.001)和抑郁(8.0%比4.7%；p<；0.001)。显示焦虑和抑郁累积发生率的曲线显示，在诊断为IBD后的一年内急剧上升，导致曲线具有恒定的斜率。与对照组(P<；0.001)相比，被诊断为克罗恩病(CD)和溃疡性结肠炎(UC)的新发焦虑症的危险比(HR)分别为1.63和1.6。与对照组相比，诊断为CD和UC后出现抑郁的HR分别为2.09和2.00(p<；0.001)。与对照组相比，IBD患者焦虑和抑郁的风险更高，除了糖尿病、高血压和血脂异常的患者，或者在IBD诊断后一年内需要免疫调节剂和生物制品的患者除外。结论：与普通人群相比，诊断为IBD后焦虑和抑郁的风险增加。
Background and Aims: Inflammatory bowel disease (IBD) may be associated with anxiety and depression. The aim of this study was to evaluate the incidence of anxiety and depression in patients with IBD compared to the general population. Methods: A nationwide population-based cohort study was conducted using claims data from the National Healthcare Insurance service in Korea. We compared the incidence of anxiety and depression between 15,569 IBD patients and 46,707 non-IBD controls, age and sex matched at a ratio of 1:3. Results: During a mean follow-up of six years, IBD patients experienced significantly more anxiety (12.2% vs. 8.7%; p < 0.001) and depression (8.0% vs. 4.7%; p < 0.001) compared to controls. The curves showing cumulative incidences of anxiety and depression showed a steep rise within one year following a diagnosis of IBD, leading to lines with a constant slope. The hazard ratio (HR) for new onset anxiety following a diagnosis of Crohn's disease (CD) and ulcerative colitis (UC) was 1.63 and 1.60, respectively, compared to controls (p < 0.001). Compared to controls, the HR for developing depression after a diagnosis of CD and UC was 2.09 and 2.00, respectively (p < 0.001). The risks of anxiety and depression in patients with IBD were higher compared to controls, except in those with diabetes mellitus, hypertension, and dyslipidemia, or who required immunomodulators and biologics within one year of the IBD diagnosis. Conclusions: The risk of anxiety and depression increased after a diagnosis of IBD compared to the general population.