Key result
Suicidal ideation occurred in 5.3% (71/1352) of IBD outpatients and was independently predicted by depression severity (β=0.46; P=0.002) and TCA use (β=0.31; P=0.012).
Observational (n=1,352)
Effect estimate: β=0.46
p-value: p=0.002
Depression severity and TCA use are significant predictors of suicidal ideation in IBD outpatients, suggesting a need for targeted behavioral screening.
SI in IBD outpatients links to depression severity and TCA use; supports screening but leaves practice change open pending trials.
BACKGROUND: Suicidal ideation (SI) is understudied in inflammatory bowel diseases (IBD). We aim to determine SI rates among IBD outpatients and to evaluate predictors of SI. MATERIALS AND METHODS: This is a prospective observational study of consecutive adult IBD outpatients over 18 months. Patients were screened for depression and SI using patient health questionnaire (PHQ-9). Demographic data were obtained from electronic medical record. Regression modeling was used for predictor analyses. RESULTS: In total, 71 of consecutive 1352 IBD outpatients had SI. Significant correlations between SI and depression severity, tricyclic antidepressants (TCA), IBD-related quality of life, and low vitamin D levels were seen. Univariate regression showed that depression severity, TCA use, and quality of life predicted SI. Multivariate regression showed depression severity (β=0.46; P=0.002) and TCA use (β=0.31; P=0.012) made unique contributions. CONCLUSIONS: SI is associated with depressive severity and less directly with IBD activity. Low-dose TCA, often used for chronic abdominal pain, is also a risk factor. Identifying the subset of IBD patients most vulnerable to SI can facilitate proper referrals to behavioral services and prevent progression to completed suicides.
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Hashash et al. (2018) conducted an observational in Inflammatory bowel diseases (IBD) (n=1,352). Depression severity and tricyclic antidepressant (TCA) use was evaluated on Suicidal ideation (β=0.46, p=0.002). Suicidal ideation occurred in 5.3% (71/1352) of IBD outpatients and was independently predicted by depression severity (β=0.46; P=0.002) and TCA use (β=0.31; P=0.012).
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