目的:评估儿童和年轻成人炎症性肠病(IBD)的心理健康共病的影响。
方法:回顾性观察研究。
方法:代表人群,从英国最佳患者护理研究数据库(2015-2019)常规收集初级护理数据。
方法:将有精神健康状况的5-25岁IBD患者与没有精神健康状况的同龄IBD患者进行比较。
方法:结果包括生活质量指标(情绪低落,自我伤害,杀寄生虫,肠道症状,不在学校或工作,失业,物质使用和睡眠障碍),IBD干预措施(药物,腹部手术,造口形成和营养补充剂)和医疗保健利用(初级保健互动和住院)。
结果:在1943名5-25岁的IBD患者中,295(15%)患有精神健康合并症。精神健康合并症与肠道症状增加相关(调整发生率比(aIRR)1.82;95%CI1.33至2.52),睡眠障碍(调整后的HR(aHR)1.63;95%CI1.02至2.62),物质使用(AHR3.63;95%CI1.69至7.78),初级护理相互作用(aIRR1.33;95%CI1.12~1.58)和住院(aIRR1.87;95CI1.29~2.75)。在年龄≥18岁的个体中,心理健康合并症与下班时间增加相关(aHR1.55;95%CI1.21~1.99).
结论:患有IBD的儿童和年轻人的心理健康合并症与较差的生活质量相关,更高的医疗保健利用率和更多的休息时间。必须对受影响的年轻IBD患者进行监测,并接受早期心理健康支持,作为他们多学科护理的一部分。
背景:事先指定并注册了研究方案(ClinicalTrials.gov研究标识符:NCT05206734)。
OBJECTIVE: To evaluate the impact of mental health comorbidity in children and young adults with inflammatory bowel disease (IBD).
METHODS: Retrospective observational study.
METHODS: Representative population, routinely collected primary care data from the UK Optimum Patient Care Research Database (2015-2019).
METHODS: Patients with IBD aged 5-25 years with mental health conditions were compared with patients with IBD of the same age without mental health conditions.
METHODS: Outcomes comprised quality-of-life indicators (low mood, self-harm, parasuicide, bowel symptoms, absence from school or work, unemployment, substance use and sleep disturbance), IBD interventions (medication, abdominal surgery, stoma formation and nutritional supplements) and healthcare utilisation (primary care interactions and hospital admissions).
RESULTS: Of 1943 individuals aged 5-25 years with IBD, 295 (15%) had a mental health comorbidity. Mental health comorbidity was associated with increased bowel symptoms (adjusted incident rate ratio (aIRR) 1.82; 95% CI 1.33 to 2.52), sleep disturbance (adjusted HR (aHR) 1.63; 95% CI 1.02 to 2.62), substance use (aHR 3.63; 95% CI 1.69 to 7.78), primary care interactions (aIRR 1.33; 95% CI 1.12 to 1.58) and hospital admissions (aIRR 1.87; 95%CI 1.29 to 2.75). In individuals ≥18 years old, mental health comorbidity was associated with increased time off work (aHR 1.55; 95% CI 1.21 to 1.99).
CONCLUSIONS: Mental health comorbidity in children and young adults with IBD is associated with poorer quality of life, higher healthcare utilisation and more time off work. It is imperative that affected young patients with IBD are monitored and receive early mental health support as part of their multidisciplinary care.
BACKGROUND: The study protocol was specified and registered a priori (ClinicalTrials.gov study identifier: NCT05206734).