학위논문 (석사)-- 서울대학교 대학원 : 의과대학 의학과, 2018. 2. 김주성.Background/Aims: Inflammatory bowel disease (IBD) may be associated with psychological disorders. The aim of this study was to investigate the risk of anxiety and depression in patients with IBD.
Methods: We conducted a retrospective study using claim data from the National Healthcare Insurance service (NHIS) in Korea. The patients with Crohns disease (CD) and ulcerative colitis (UC) were identified through both ICD-10 codes and the rare/intractable disease registration program codes which provide co-payment reduction of up to 90% in Korea. We compared 15,569 IBD patients with 46,707 non-IBD controls matched by age and sex with a ratio of 1:3. Cases with newly diagnosed anxiety and depression were identified through ICD-10 codes in the study population, respectively. The Kaplan–Meier method was used to estimate the cumulative probability of anxiety and depression in IBD patients.
Results: During the mean follow-up of 6 years, IBD patients experienced anxiety and depression more frequently than non-IBD controls, respectively (anxiety: 12.2% vs. 8.7%, p<0.001depression: 8.0% vs. 4.7%, p<0.001). In patients with CD, incidence rate (per 1,000 person-years) of anxiety was 19.51, compared to 13.26 in controls (hazard ratio [HR], 1.6395% confidence interval [CI], 1.40-1.89p<0.001), and incidence rate of depression was 12.79, compared to 6.6 in controls (HR, 2.0995% CI, 1.73-2.52p<0.001). In patients with UC, incidence rate (per 1,000 person-years) of anxiety was 28.9, compared to 19.87 in controls (HR, 1.6095% CI, 1.44-1.77p<0.001), and incidence rate of depression was 16.49, compared to 9.23 per in controls (HR, 2.0095% CI, 1.74-2.30p<0.001). The impact of CD on developing depression was more pronounced in male gender (adjusted HR, 1.5895% CI, 1.41-1.76) than in female (adjusted HR, 1.2195% CI, 1.00-1.47p=0.025 by interaction analysis).
Conclusion: The risk of anxiety and depression increased in the patients with IBD, respectively. Patients with IBD would be monitored carefully for the development of mood disorders.Introduction 1
Methods 3
Results 6
Discussion 16
References 19
Abstract (Korean) 22Maste
