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IBD Linked to Higher Risk of Suicide Ideation, Attempts, and Death

Patients with Crohn’s disease subtype, females, pediatric-onset IBD, young adult patients with IBD, and patients with short-duration IBD were all at a higher risk for suicide.

New research indicates that a diagnosis of inflammatory bowel disease (IBD) does lead to a heightened risk of suicide ideation, suicide attempts, and suicide deaths.

A team, led by Xiong Qin, Chengdu University of Traditional Chinese Medicine, identified the relationship between IBD and suicidal ideation, suicide attempts, and suicide.

Psychiatric Comorbidities

IBD is often associated with an increased risk of psychiatric comorbidities, but the association between IBD and suicidal ideation or suicide attempts is not yet known.

In the systematic review and meta-analysis, the investigators identified studies from the inception of various databases to January 28, 2022 and performed quality assessments, data synthesis, subgroup analyses, sensitivity analyses, and publication bias assessments on the identified studies.

Overall, they included 28 studies in the final analysis involving 1.05 million individuals with IBD.

The pooled prevalence of suicidal ideation in patients with IBD was 17.3% (95% CI, 9.5-25.2%) and patients with IBD had an increased risk of suicide attempts (RR, 1.39; 95% CI, 1.08-1.79), as well as suicide deaths (RR, 1.25; 95% CI, 1.09-1.43) when compared to a control group of participants without IBD.

Trends

There was also some demographic trends that lead to an increased risk of suicide.

For example, patients with Crohn’s disease subtype, females with IBD, patients with pediatric-onset IBD, young adult patients with IBD, and patients with short-duration IBD were all at a higher risk for suicide.

“Patients with IBD had a high prevalence of suicidal ideation and a significantly higher likelihood of suicide attempts and suicide,” the authors wrote. “Caring for patients with IBD, including their mental health needs, may require concerted efforts among gastroenterologists and other healthcare providers.”

Depression and IBD

Earlier this year, investigators explored another psychiatric connection with the gastrointestinal disease—IBD and depression.

The data on patients with inflammatory bowel disease (IBD) and depression and their unaffected siblings could shed light on the gut-brain axis influence on the pathophysiology of IBD.

About 30% of patients with IBD also have concurrent depression.

In the parallel, retrospective, cohort analysis, the investigators used data from the Taiwanese National Health Insurance Research Database to follow individuals up to 11 years for new-onset depression or IBD.

The investigators also matched unaffected siblings to controls based on predefined characteristics.

In the follow-up period, 18.5% (n = 78) of patients with IBD, 4.8% (n = 26) of unaffected siblings, and 2.5% (n = 54) of the control group developed depression.

The adjusted odds-ratios (OR) for depression for patients with IBD was 9.43 (95% CI, 6.43-13.81; P <0.001), compared to 1.82 (95% CI, 1.14-2.91; P = 0.013) for unaffected siblings.

The investigators also looked at the risk of IBD for patients with depression. In this group, the investigators identified 25,552 patients with depression, 26,147 unaffected siblings, and 104,588 control participants.

In the follow-up period, 18 (0.70 per 1000) depression patients developed IBD, compared to 25 (0.96 per 1000) unaffected siblings, and 58 (0.55 per 1000). The odds ratios for IBD for patients with depression was 1.87 (95% CI, 1.07-3.26; P = 0.028), compared to 1.69 (95% CI, 1.05-2.69; P = 0.029) for the unaffected siblings.

The study, “Association of inflammatory bowel disease with suicidal ideation, suicide attempts, and suicide: A systematic review and meta-analysis,” was published in the Journal of Psychosomatic Research.