Background Inflammatory bowel disease (IBD) has a significant impact on quality of life for many people. Objective To assess the prevalence of common mental health conditions in IBD and the combined impact of IBD and mental health conditions on healthcare use and time off work. Methods A UK population-based primary care database (Royal College of General Practitioners Research and Surveillance Centre) was used to identify adults with IBD (n=19 011) (Crohn’s disease (CD) or ulcerative colitis (UC)), and matched controls (n=76 044). Prevalences of anxiety, depressive episodes and depressive disorder recorded in primary care were assessed between 2016 and 2018. Outcomes comprised of rates of primary care visits, emergency secondary care visits, certificates for time off work, antidepressant and anxiolytic prescriptions. Findings Mental health conditions were more common in people with CD than controls: anxiety episodes (3.5% vs 3.0%; p=0.02), depressive episodes (5.7% vs 4.1%; p<0.001) and depressive disorder (17.5% vs 12.9%; p<0.001), and people with UC versus controls: depressive episodes (4.4% vs 3.6%; p<0.001) and depressive disorder (14.2% vs 12.4%; p<0.001). Healthcare utilisation rates were higher in people with IBD than controls (primary care visits incidence rate ratio 1.47 (95% CI 1.43 to 1.51); emergency secondary care visits 1.87 (1.79 to 1.95); fitness for work certificates 1.53 (1.44 to 1.62); antidepressant use 1.22 (1.13 to 1.32); anxiolytic use 1.20 (1.01 to 1.41)). In people with IBD, mental health conditions were associated with additional increases in healthcare use and time off work. Conclusion Depression and anxiety are more common in people with IBD than matched controls. Healthcare utilisation and prescribing of psychotropic medications are also higher in people with IBD. Mental health conditions in people with IBD are associated with additional healthcare use and time off work. Clinical implications Evidence-based mental health support programmes, including psychological treatments, are needed for people with IBD. Data may be obtained from a third party and are not publicly available. The RCGP RSC dataset is held securely at Oxford University and the University of Surrey and can be accessed by bona fide researchers. Approval is on a project-by-project basis (www.rcgp.org.uk/rsc). Ethical approval by an NHS Research Ethics Committee may be needed before any data release/other appropriate approval. Researchers wishing to directly analyse the patient-level pseudonymised data will be required to complete information governance training and work on the data from university secure servers. Patient-level data cannot be taken out of the secure network.

中文翻译：

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炎症性肠病患者抑郁和焦虑的患病率及相关医疗保健使用：基于人群的队列研究


背景 炎症性肠病（IBD）对许多人的生活质量有重大影响。目的 评估 IBD 常见心理健康状况的患病率以及 IBD 和心理健康状况对医疗保健使用和休假的综合影响。方法 使用英国基于人群的初级保健数据库（皇家全科医师学院研究和监测中心）来识别患有 IBD 的成人 (n=19 011)（克罗恩病 (CD) 或溃疡性结肠炎 (UC)），并进行匹配对照（n=76 044）。对 2016 年至 2018 年间记录的初级保健中焦虑、抑郁发作和抑郁症的患病率进行了评估。结果包括初级保健就诊率、紧急二级保健就诊率、下班证明、抗抑郁药和抗焦虑药处方。结果 CD 患者的心理健康状况比对照组更常见：焦虑发作（3.5% vs 3.0%；p=0.02）、抑郁发作（5.7% vs 4.1%；p<0.001）和抑郁症（17.5% vs 12.9%） ；p<0.001），UC 患者与对照组相比：抑郁发作（4.4% vs 3.6%；p<0.001）和抑郁障碍（14.2% vs 12.4%；p<0.001）。 IBD 患者的医疗保健利用率高于对照组（初级保健就诊发生率 1.47（95% CI 1.43 至 1.51）；紧急二级保健就诊 1.87（1.79 至 1.95）；适合工作证书 1.53（1.44 至 1.62）；抗抑郁药的使用 1.22（1.13 至 1.32）；抗焦虑药的使用 1.20（1.01 至 1.41））。在 IBD 患者中，心理健康状况与医疗保健使用和休假时间的额外增加有关。结论 IBD 患者的抑郁和焦虑比匹配的对照组更常见。 IBD 患者的医疗保健利用率和精神药物处方也较高。 IBD 患者的心理健康状况与额外的医疗保健使用和休假有关。临床意义 IBD 患者需要基于证据的心理健康支持计划，包括心理治疗。数据可能从第三方获得，并且不公开。 RCGP RSC 数据集安全地保存在牛津大学和萨里大学，可供真正的研究人员访问。批准是根据每个项目进行的（www.rcgp.org.uk/rsc）。在任何数据发布/其他适当批准之前，可能需要 NHS 研究伦理委员会的伦理批准。希望直接分析患者级假名数据的研究人员将需要完成信息治理培训并处理来自大学安全服务器的数据。患者级数据无法从安全网络中取出。