Childhood appendectomy and subsequent psychiatric illness

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.