Psychiatric comorbidity in childhood onset immune-mediated diseases-A systematic review and meta-analysis
Sabine Jansson1,2, Mikkel Malham1,3, Vibeke Wewer1
1The Pediatric Department, Copenhagen University Hospital, Hvidovre, Denmark.
Insights
Anxiety and depression are common in children with immune-mediated inflammatory diseases (IMID). Healthcare providers should monitor for these mental health issues in pediatric patients with IMID.
Area of Science:
- Pediatric Rheumatology
- Pediatric Gastroenterology
- Child Psychiatry
Background:
- Childhood onset immune-mediated inflammatory diseases (IMID) encompass conditions like inflammatory bowel disease (IBD) and rheumatic diseases (RD).
- These chronic conditions can significantly impact a child's quality of life and may be associated with psychological distress.
Purpose of the Study:
- To estimate the prevalence of psychiatric comorbidities in children diagnosed with IMID.
- To synthesize existing data on mental health conditions in pediatric IBD and RD patients.
Main Methods:
- A systematic literature search was conducted across PubMed, PsycINFO, and Embase following PRISMA guidelines.
- Random-effects meta-analysis was used to pool prevalence rates of psychiatric disorders (anxiety, mood disorders) in pediatric IBD and RD.
- Risk of bias was assessed using the Newcastle-Ottawa scale.
Main Results:
- The meta-analysis included 23 studies, focusing on pediatric IBD (13 studies) and RD (10 studies).
- Prevalence rates for anxiety disorders in pediatric IBD ranged from 6% (register-based) to 33% (psychiatric assessment).
- Mood disorder prevalence in pediatric IBD was 4% (register-based) to 18% (psychiatric assessment), while in RD, it was 20% (psychiatric assessment).
Conclusions:
- Anxiety and depression are frequently observed in children with IMID.
- There is a need for increased clinical attention to mental health challenges in pediatric IMID patients, as these may be underdiagnosed.
Aim:
To estimate psychiatric comorbidity in childhood onset immune-mediated inflammatory diseases (IMID).
Methods:
The PRISMA guidelines were followed, and the protocol was registered at Prospero (ID: CRD42021233890). Literature was searched in PubMed, PsycINFO and Embase. Original papers on prevalence rates of diagnosed psychiatric disorders and/or suicide in paediatric onset inflammatory bowel disease (pIBD), rheumatic diseases (RD) and autoimmune liver diseases were selected. Pooled prevalence rates of psychiatric disorders (grouped according to ICD-10 criteria) within the various IMID were calculated using random-effects meta-analysis. Risk of bias was evaluated by the Newcastle-Ottawa scale.
Results:
Twenty-three studies were included; 13 describing psychiatric disorders in pIBD and 10 in RD. Anxiety and mood disorders were mostly investigated with pooled prevalence rates in pIBD of 6% (95% confidence interval (CI): 4%-9%) and 4% (95%CI: 2%-8%), respectively, in register-based studies, and 33% (95%CI: 25%-41%) and 18% (95%CI: 12%-26%), respectively, in studies using psychiatric assessment. In RD, rates were 13% (95%CI: 12%-15%) for anxiety disorders and 20% (95%CI: 15%-26%) for mood disorders based on psychiatric assessment.
Conclusion:
Anxiety and depression are commonly reported in childhood onset IMID. Physicians should be attentive to mental health problems in these patients as they seem overlooked.
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