Examining the link between IBD and psychiatric disorders

Does childhood-onset inflammatory bowel disease (IBD) increase the risk of psychiatric disorders or suicide attempts? A study from the Karolinska Institutet in Solna, Sweden, examines whether the link exists.

Researchers used data collected from the Swedish national healthcare and population registers, which included all children and adolescents aged younger than 18 years who were born from 1973 to 2013. They found 6464 people with a diagnosis of childhood-onset IBD: 3228 with ulcerative colitis, 2536 with Crohn disease, and 700 with unclassified IBD. These children were compared with 323,200 matched reference individuals from the general population as well as 6999 people who had siblings with IBD.

In the cohort, researchers found that during the median follow-up time of 9 years, 1117 (17.3%) people with IBD were given a diagnosis for any psychiatric disorder (incidence rate, 17.1 per 1000 person-years) compared with 38,044 (11.8%) people in the general population (incidence rate, 11.2 per 1000 person-years). When looking at the people with some form of IBD, they found that it was significantly linked with eating disorders (hazard ratio [HR], 1.6; 95% confidence interval [CI], 1.3-2.0), autism spectrum disorders (HR, 1.4; 95% CI, 1.1-1.7), personality disorders (HR, 1.4; 95% CI, 1.1-1.8), attention-deficit/hyperactivity disorder (HR, 1.2; 95% CI, 1.1-1.4), suicide attempts (HR, 1.4; 95% CI, 1.2-1.7), anxiety disorders (HR, 1.9; 95% CI, 1.7-2.0), and mood disorders (HR, 1.6; 95% CI, 1.4-1.7). Boys and girls had similar results. The HR for psychiatric disorders was highest in the first year of follow-up, but it remained statistically significant after more than 5 years. Disorders were found to be common among people with parental psychiatric history or very early-onset IBD (<6 years).

The researchers concluded that childhood-onset IBD does have a link with psychiatric morbidity. They found the increased risk of suicide attempt to be particularly concerning and that long-term support should be considered for children who have been diagnosed with childhood-onset IBD.