Citation

Malham M, Jakobsen C, Paerregaard A, Hald M, Virta L, Kolho KL, Wewer V. Aliment. Pharmacol. Ther. 2020; 51(11): 1214-1215.

Copyright

(Copyright © 2020, John Wiley and Sons)

DOI

10.1111/apt.15733

PMID

unavailable

Abstract

Increasing attention has recently been given to the decreased quality of life that is experienced by patients with inflammatory bowel disease (IBD). In their letter, Sánta et al present data from a questionnaire, finding that a surprisingly high proportion of IBD patients in Hungary were at risk of suicide (16%).1 This is in line with the previously published paper by Gradus et al reporting an increased risk of suicide in the Danish IBD population from 1981 to 2006.2 In 2019, we found that paediatric onset IBD (pIBD) is associated with a fourfold increased risk of suicide,3 which is twice the risk estimate found in most adult onset IBD (aIBD) studies. All but two of the patients who committed suicide were over 18 years (median 21.0 [IQR: 19‐24]), which we did not report in the paper. Due to our study design, a further elaboration on the possible reasons for this worrying result was impossible, but we speculated that it might be due to the aggressive disease course previously reported in the pIBD population.4 However, Olen et al subsequently published results from the Swedish pIBD population, which showed that the risk of both psychiatric diagnoses and suicide attempts were increased.5 This underlines that the burden of psychiatric comorbidity is high in this patient group and stresses the statement made by Drs Banerjee and Gearry in their editorial in connection with our original paper, describing it as "a call to action".6 However, it needs to be clarified what this action should be. It seems evident that there is a high incidence of psychiatric comorbidity in the pIBD population, and the time has passed for additional descriptive studies. We therefore need to incorporate psychological and psychiatric health professionals into the standard of care in IBD, and not simply focus on somatic disorders, that is, the gastrointestinal tract. As proposed in the letter by Santa et al a psychological screening as part of a standardised transition programme could be useful in adult care. This would identify high‐risk patients and would furthermore focus the health professionals' resources to patients needing them the most.

Lastly, in most developed countries...

Language: en