Stoma Formation in Crohn's Disease and the Likelihood of Antidepressant Use : A Population-Based Cohort Study
Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved..
BACKGROUND & AIMS: The impact of a temporary or permanent stoma on mental health in Crohn's Disease (CD) is unknown. The aim was to examine the association between intestinal surgery and stoma formation and subsequent antidepressant medication (ADM) use.
METHODS: Using the Clinical Practice Research Datalink, we identified individuals with CD who underwent intestinal surgery between 1998-2018. We excluded individuals with a prescription for an ADM in the 6 months before surgery. Individuals were stratified into three groups: no stoma, temporary stoma, and permanent stoma. We used Kaplan-Meier curves to examine initiation of ADM after intestinal surgery and Cox regression to identify risk factors for ADM use after intestinal surgery.
RESULTS: We identified 1,272 cases of CD undergoing their first intestinal surgery. Of these, 871 (68.5%) had no stoma, 191 (15.0%) had a temporary stoma and 210 (16.5%) had a permanent stoma. The 10-year cumulative incidence of ADM use was 26.4%, 33.4% and 37.3% respectively. Individuals with a permanent stoma were 71% more likely to receive an ADM than those with no stoma (HR 1.71, 95% CI 1.20-2.44). Individuals with a temporary stoma reversed within 12 months had a similar likelihood of ADM use to those without stoma formation (HR 0.99, 95% CI 0.64-1.53) whereas temporary stoma formation with late reversal after 12 months was associated with significantly greater likelihood of ADM use (HR 1.85, 95% CI 1.15-2.96).
CONCLUSIONS: Permanent stomas and temporary stomas with late reversal surgery are associated with increased ADM use after intestinal surgery, likely associated with increased anxiety and depression.
| Errataetall: |
CommentIn: Clin Gastroenterol Hepatol. 2022 Jan;20(1):245-246. - PMID 33581361 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:20 |
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| Enthalten in: |
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association - 20(2022), 4 vom: 15. Apr., Seite e703-e710 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Blackwell, Jonathan [VerfasserIn] |
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| Links: |
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| Themen: |
Antidepressants |
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| Anmerkungen: |
Date Completed 16.03.2022 Date Revised 16.03.2022 published: Print-Electronic CommentIn: Clin Gastroenterol Hepatol. 2022 Jan;20(1):245-246. - PMID 33581361 Citation Status MEDLINE |
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| doi: |
10.1016/j.cgh.2020.12.026 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM319240568 |
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| 100 | 1 | |a Blackwell, Jonathan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Stoma Formation in Crohn's Disease and the Likelihood of Antidepressant Use |b A Population-Based Cohort Study |
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| 500 | |a Date Revised 16.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Clin Gastroenterol Hepatol. 2022 Jan;20(1):245-246. - PMID 33581361 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND & AIMS: The impact of a temporary or permanent stoma on mental health in Crohn's Disease (CD) is unknown. The aim was to examine the association between intestinal surgery and stoma formation and subsequent antidepressant medication (ADM) use | ||
| 520 | |a METHODS: Using the Clinical Practice Research Datalink, we identified individuals with CD who underwent intestinal surgery between 1998-2018. We excluded individuals with a prescription for an ADM in the 6 months before surgery. Individuals were stratified into three groups: no stoma, temporary stoma, and permanent stoma. We used Kaplan-Meier curves to examine initiation of ADM after intestinal surgery and Cox regression to identify risk factors for ADM use after intestinal surgery | ||
| 520 | |a RESULTS: We identified 1,272 cases of CD undergoing their first intestinal surgery. Of these, 871 (68.5%) had no stoma, 191 (15.0%) had a temporary stoma and 210 (16.5%) had a permanent stoma. The 10-year cumulative incidence of ADM use was 26.4%, 33.4% and 37.3% respectively. Individuals with a permanent stoma were 71% more likely to receive an ADM than those with no stoma (HR 1.71, 95% CI 1.20-2.44). Individuals with a temporary stoma reversed within 12 months had a similar likelihood of ADM use to those without stoma formation (HR 0.99, 95% CI 0.64-1.53) whereas temporary stoma formation with late reversal after 12 months was associated with significantly greater likelihood of ADM use (HR 1.85, 95% CI 1.15-2.96) | ||
| 520 | |a CONCLUSIONS: Permanent stomas and temporary stomas with late reversal surgery are associated with increased ADM use after intestinal surgery, likely associated with increased anxiety and depression | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Antidepressants | |
| 650 | 4 | |a Crohn's Disease | |
| 650 | 4 | |a Psychosomatic Medicine | |
| 650 | 4 | |a Stoma | |
| 650 | 7 | |a Antidepressive Agents |2 NLM | |
| 700 | 1 | |a Saxena, Sonia |e verfasserin |4 aut | |
| 700 | 1 | |a Jayasooriya, Nishani |e verfasserin |4 aut | |
| 700 | 1 | |a Petersen, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Hotopf, Matthew |e verfasserin |4 aut | |
| 700 | 1 | |a Creese, Hanna |e verfasserin |4 aut | |
| 700 | 1 | |a Bottle, Alex |e verfasserin |4 aut | |
| 700 | 1 | |a Pollok, Richard C G |e verfasserin |4 aut | |
| 700 | 0 | |a POP-IBD Study Group |e verfasserin |4 aut | |
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