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Temporal trends in depression-related hospitalizations and suicide among patients with inflammatory bowel disease
Ante Markovinović1,2, Christopher Ma1,2, Abdel-Aziz Shaheen1,2
1Department of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada.
Background:
Individuals with inflammatory bowel disease (IBD) are at higher risk of depression. However, data on depression-related hospitalizations and suicide death remain limited.
Methods:
This population-based study used administrative data to identify annual prevalent cohorts of individuals with IBD and matched controls between fiscal years 2005/2006 to 2021/2022. The primary outcomes were hospitalization for depression and suicide death. An IBD incident cohort was used to estimate the 1-, 3-, and 5-year cumulative incidence with 95% confidence intervals (CIs). Temporal trends were evaluated by calculating the average annual percent change (AAPC) using Poisson or negative binomial regression models. Conditional logistic regression estimated the odds ratio (OR) for depression-related hospitalizations between individuals with and without IBD.
Results:
Individuals with IBD had higher odds of depression-related hospitalization than matched controls (OR = 1.52; 95% CI, 1.38, 1.67). Over time, depression-related hospitalizations decreased in those with IBD (AAPC: -3.38%; 95% CI, -4.72, -2.03), driven by Crohn's disease (AAPC: -4.76; 95% CI, -7.06, -2.39), whereas rates were stable in ulcerative colitis (AAPC: -1.71%; 95% CI, -4.46, 1.11). Hospitalization rates for depression in IBD declined in adults but were stable for pediatric patients (2.56%; 95% CI, -7.17, 13.30). Suicide deaths occurred in 0.21% (95% CI, 0.17, 0.25) of those with IBD and were stable over time (AAPC: -0.99%; 95% CI, -2.44, 0.48). The 1-, 3-, and 5-year cumulative incidence of depression-related hospitalization in the IBD incident cohort was 0.16% (95% CI, 0.12, 0.22), 0.41% (95% CI, 0.33, 0.50), and 0.63% (95% CI, 0.52, 0.75), respectively.
Conclusions:
Depression-related hospitalizations declined among individuals with IBD, particularly those with Crohn's disease, whereas suicide rates were stable.
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