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Childhood appendectomy and subsequent psychiatric illness.

Cecilia Arana Håkanson1, Fredrik Stiger2, Nele Brusselaers3,4

  • 1Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.

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Childhood appendectomy is linked to a higher risk of psychiatric illness and increased healthcare use later in life. This study highlights potential long-term health consequences of appendix removal in children.

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Area of Science:

  • Gastroenterology and Psychiatry
  • Microbiome Research
  • Public Health

Background:

  • The appendix serves as a reservoir for gut microbiota, aiding in gut microbiome restoration.
  • Appendectomy, particularly in childhood, may lead to lasting microbiome disruptions and associated health issues.
  • Understanding the long-term impact of childhood appendectomy on mental health is crucial.

Purpose of the Study:

  • To investigate the association between childhood appendectomy and the subsequent risk of psychiatric illness.
  • To explore the relationship between childhood appendectomy and healthcare consumption for psychiatric conditions.
  • To assess potential long-term health consequences of early-life appendectomies.

Main Methods:

  • A cohort study involving 752 individuals who underwent childhood appendectomy, matched with 3760 controls.
  • Data on psychiatric diagnoses, healthcare visits, and psychiatric medication use were obtained from Swedish population registers.
  • Stratified Cox and Poisson regression analyses were employed, with adjustments for antibiotic, proton pump inhibitor, and non-steroidal anti-inflammatory drug use.

Main Results:

  • Individuals who had a childhood appendectomy showed a significantly increased risk of general psychiatric illness (HR 1.19) and affective disorders (HR 1.20).
  • Both outpatient (IRR 1.20) and inpatient psychiatric healthcare visits were more frequent in the appendectomy group.
  • The median age at appendectomy was 11 years, with a median follow-up of 15.5 years.

Conclusions:

  • Childhood appendectomy is associated with an elevated risk of developing psychiatric illnesses.
  • The study indicates a higher likelihood of psychiatric healthcare consumption following childhood appendectomy.
  • These findings suggest a potential link between appendix removal in childhood and long-term mental health outcomes.