What question did this study set out to answer?

To evaluate the impact of new-onset depression and specific antidepressant therapies on the subsequent incidence of Crohn's disease and ulcerative colitis.

October 18, 2018Gut

Depression increases the risk of inflammatory bowel disease, which may be mitigated by the use of antidepressants in the treatment of depression

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Depression and Inflammatory Bowel Disease. Intervention: Depression vs. Patients who did not meet the defining criteria for depression. Primary outcome: Incident Crohn's disease (CD) or ulcerative colitis (UC) (HR 2.11, 95% CI 1.65-2.70).

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Key result

Individuals with depression had a significantly greater risk of developing Crohn's disease (HR 2.11; 95% CI 1.65-2.70) and ulcerative colitis (HR 2.23; 95% CI 1.92-2.60).

Why the study?

Does depression increase the risk of developing inflammatory bowel disease, and do antidepressants mitigate this risk?

Population

Patients in The Health Improvement Network from 1986 to 2012, including 403,665 with new-onset depression.

Comparison

Depression vs Patients who did not meet the defining criteria…

Design

Cohort

Authors

AFAlexandra FrolkisUniversity of Calgary IVIsabelle A. VallerandUniversity of Calgary ASAbdel Aziz ShaheenWestern University

Discussion

Member takes

Implication

Depression history may signal higher IBD risk; hypothesis-generating for selective antidepressant protection pending prospective trials.

Key Points

To evaluate the impact of new-onset depression and specific antidepressant therapies on the subsequent incidence of Crohn's disease and ulcerative colitis.
Analyzed longitudinal records from The Health Improvement Network (THIN) between 1986 and 2012, identifying individuals with incident depression compared to an unexposed referent group.
Tracked incident diagnoses of Crohn's disease (CD) and ulcerative colitis (UC).
Applied Cox proportional hazards modeling adjusting for age, sex, socioeconomic status, comorbidities, smoking, anxiety, and specific antidepressant classes.
Among 403,665 patients with incident depression (7.05% of the cohort), depression was linked to a higher risk of developing CD (adjusted HR=2.11, 95% CI 1.65 to 2.70) and UC (adjusted HR=2.23, 95% CI 1.92 to 2.60).
Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) were protective against developing CD.
Mirtazapine, SNRIs, SSRIs, serotonin modulators, and TCAs demonstrated protective associations against developing UC.

Study Design

Type

Cohort

Structured PICO

Does depression increase the risk of developing inflammatory bowel disease, and do antidepressants mitigate this risk?

Population

A cohort study from 1986 to 2012 including 403,665 patients with incident depression and a referent group without depression to evaluate the risk of developing Crohn's disease or ulcerative colitis.

Exposure

Depression (and use of antidepressant therapies including atypical antidepressants, mirtazapine, MAOI, SNRI, SSRI, serotonin modulators, and TCA)

Comparator

Patients who did not meet the defining criteria for depression

Outcome

Incident Crohn's disease (CD) or ulcerative colitis (UC)hard clinical

Main Result

Hazard Ratio: 2.11 (95% CI 1.65–2.7)

Depression is associated with an increased risk of developing Crohn's disease and ulcerative colitis, which may be selectively mitigated by certain antidepressant treatments.

Cite This Study

Frolkis et al. (2018) conducted a cohort in Depression and Inflammatory Bowel Disease. Depression vs. Patients who did not meet the defining criteria for depression was evaluated on Incident Crohn's disease (CD) or ulcerative colitis (UC) (HR 2.11, 95% CI 1.65-2.70). Individuals with depression had a significantly greater risk of developing Crohn's disease (HR 2.11; 95% CI 1.65-2.70) and ulcerative colitis (HR 2.23; 95% CI 1.92-2.60).

synapsesocial.com/papers/6a6dff5035aa2c282ce016e7 https://doi.org/10.1136/gutjnl-2018-317182

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Depression increases the risk of inflammatory bowel disease, which may be mitigated by the use of antidepressants in the treatment of depression

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Depression increases the risk of inflammatory bowel disease, which may be mitigated by the use of antidepressants in the treatment of depression

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider