People with inflammatory bowel disease (IBD) may be at a higher risk of suicide than those without this disorder, according to a study by researchers in Canada. Their findings indicate that proper assessment and treatment of mental health is key in IBD patients.
Research has shown that IBD has a marked psychological impact, including depression and anxiety, and affects quality of life.
Previous research undertaken in Canada found that chronic illnesses such as Crohn’s disease (CD), a type of IBD, asthma and diabetes increased the odds of both suicidal thoughts and suicide attempts in young people ages 15 to 30.
Results of two national surveys in that country also demonstrated that 17% of IBD patients experiencing depression considered suicide to some extent in the previous year.
Still, the risk of suicide in IBD patients is unclear. Given IBD’s prevalence and economic costs, scientists at the University of British Columbia investigated whether these patients have a higher incidence of suicide.
They conducted a systematic review of two online databases and a meta-analysis — a type of statistical analysis that combines the results of various studies.
From their literature searches, the investigators gathered information from seven studies of suicide in IBD that reported the standardized mortality ratio (SMR) – the proportion of observed deaths in a study population vs. the number of deaths that would be expected. An SMR value significantly above 1.0 means that there are more deaths than expected in that specific group.
A meta-analysis was conducted for Crohn’s and for ulcerative colitis (UC), another IBD type, as well as combined.
Results showed that the SMR for suicide in patients with IBD was 1.20. When each IBD type was analyzed separately, the SMR for CD and UC were 1.36 and 1.16, respectively. Although these values were above 1.0, they were not statistically significant. Still, these results indicate that IBD patients in this study had a trend toward a higher than usual death rate due to suicide.
The data also showed that the overall SMR for CD and UC in women was higher than in men, but the researchers cautioned that the lack of statistical significance does not allow for definitive conclusions. They added that the analyzed death records likely underestimated the number of suicides, as deaths may have been categorized to unknown or other causes.
Overall, “these results highlight the importance physicians must place on ensuring the mental health of patients with IBD is both assessed and treated appropriately,” the researchers wrote.
Reports that depression can worsen disease course, and that psychological therapies may ease depression and improve quality of life in IBD patients seem support their conclusion.