King's College London

TY - JOUR

T1 - Antidepressant medication use in Inflammatory Bowel Disease

T2 - a nationally representative population-based study

AU - POP-IBD Study Group

AU - Jayasooriya, Nishani

AU - Blackwell, Jonathan

AU - Saxena, Sonia

AU - Bottle, Alex

AU - Petersen, Irene

AU - Creese, Hanna

AU - Hotopf, Matthew

AU - Pollok, Richard C.G.

N1 - Funding Information: JB was funded by Crohn’s and Colitis UK Grant [grant number: SP2018/3]. RP received support by a Wellcome Trust Institute Strategic Support Fund (ISSF) grant. MH acknowledges support from the National Institute of Health Research Biomedical Research Centre at the Maudsley and is an NIHR Senior Investigator. SS is funded by the National Institute for Health Research (NIHR) School for Public Health Research (SPHR) and NIHR Northwest London Applied Research Collaboration (ARC). [Grant number: PD-SPH-2015]. The School for Public Health Imperial College London is also grateful for support from the Imperial NIHR Biomedical Research Centre. The NIHR School for Public Health Research is a partnership between the Universities of Sheffield; Bristol; Cambridge; Imperial; and University College London; The London School for Hygiene and Tropical Medicine (LSHTM); LiLaC—a collaboration between the Universities of Liverpool and Lancaster; and Fuse - The Centre for Translational Research in Public Health a collaboration between Newcastle, Durham, Northumbria, Sunderland and Teesside Universities. The Dr Foster Unit at Imperial is affiliated with the National Institute of Health Research (NIHR) Imperial Patient Safety Translational Research Centre. The NIHR Imperial Patient Safety Translational Centre is a partnership between the Imperial College Healthcare NHS Trust and Imperial College London. The Dr Foster Unit at Imperial College are grateful for support from the NIHR Biomedical Research Centre funding scheme. The views expressed in this publication are those of the authors and not necessarily those of Crohn’s & Colitis UK, the NHS, the NIHR or the Department of Health. Funding Information: JB was funded by Crohn’s and Colitis UK Grant [grant number: SP2018/3]. RP received support by a Wellcome Trust Institute Strategic Support Fund (ISSF) grant. MH acknowledges support from the National Institute of Health Research Biomedical Research Centre at the Maudsley and is an NIHR Senior Investigator. SS is funded by the National Institute for Health Research (NIHR) School for Public Health Research (SPHR) and NIHR Northwest London Applied Research Collaboration (ARC). [Grant number: PD‐SPH‐2015]. The School for Public Health Imperial College London is also grateful for support from the Imperial NIHR Biomedical Research Centre. The NIHR School for Public Health Research is a partnership between the Universities of Sheffield; Bristol; Cambridge; Imperial; and University College London; The London School for Hygiene and Tropical Medicine (LSHTM); LiLaC—a collaboration between the Universities of Liverpool and Lancaster; and Fuse ‐ The Centre for Translational Research in Public Health a collaboration between Newcastle, Durham, Northumbria, Sunderland and Teesside Universities. The Dr Foster Unit at Imperial is affiliated with the National Institute of Health Research (NIHR) Imperial Patient Safety Translational Research Centre. The NIHR Imperial Patient Safety Translational Centre is a partnership between the Imperial College Healthcare NHS Trust and Imperial College London. The Dr Foster Unit at Imperial College are grateful for support from the NIHR Biomedical Research Centre funding scheme. The views expressed in this publication are those of the authors and not necessarily those of Crohn’s & Colitis UK, the NHS, the NIHR or the Department of Health. Funding Information: This work was supported by the Living with IBD Research Programme at Crohn’s & Colitis UK [grant number: SP2018/3]. This funding source had no role in the design or execution of this study or in the analysis and interpretation of the data. The views expressed are those of the authors and not necessarily those of Crohn’s & Colitis UK. Funding information Funding Information: JB was funded by Crohn’s and Colitis UK Grant [grant number: SP2018/3] RP received support by a Wellcome Trust Institute Strategic Support Fund (ISSF) grant. SS is funded by the National Institute for Health Research (NIHR) School for Public Health Research (SPHR) and NIHR Northwest London Applied Research Collaboration (ARC). [Grant number: PD‐SPH‐2015]. The School for Public Health Imperial College London is also grateful for support from the Imperial NIHR Biomedical Research Centre. The NIHR School for Public Health Research is a partnership between the Universities of Sheffield; Bristol; Cambridge; Imperial; and University College London; The London School for Hygiene and Tropical Medicine (LSHTM); LiLaC – a collaboration between the Universities of Liverpool and Lancaster; and Fuse ‐ The Centre for Translational Research in Public Health a collaboration between Newcastle, Durham, Northumbria, Sunderland and Teesside Universities MH acknowledges support from the National Institute of Health Research Biomedical Research Centre at the Maudsley and is an NIHR Senior Investigator. The Dr Foster Unit at Imperial is affiliated with the National Institute of Health Research (NIHR) Imperial Patient Safety Translational Research Centre. The NIHR Imperial Patient Safety Translational Centre is a partnership between the Imperial College Healthcare NHS Trust and Imperial College London. The Dr Foster Unit at Imperial College are grateful for support from the NIHR Biomedical Research Centre funding scheme. The views expressed in this publication are those of the authors and not necessarily those of Crohn’s & Colitis UK, the NHS, the NIHR or the Department of Health Personal and funding interest: Publisher Copyright: © 2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.

PY - 2022/5

Y1 - 2022/5

N2 - Background: Despite high rates of depression and anxiety, little is known about the use of antidepressants amongst individuals diagnosed with inflammatory bowel disease (IBD). Aims: To evaluate temporal trends in the use of antidepressants; rates of antidepressant initiation and adherence of antidepressant use to international guidelines amongst individuals with IBD. Methods: This is a study of 14,525 incident IBD cases from 2004 to 2016 compared with 58,027 controls matched 1:4 for age and sex from the Clinical Practice Research Datalink. After excluding tricyclic antidepressants, we performed a Cox regression analysis to determine the risk associated with antidepressant use and logistic regression analysis to determine risk associated with antidepressant undertreatment. Results: Antidepressant use amongst individuals with IBD increased by 51% during the 12-year study period, who were 34% more likely to initiate antidepressants in the year after IBD diagnosis compared with controls (aHR:1.34, 95% CI 1.21-1.49). In those with IBD starting antidepressants, 67% received treatment lasting less than the duration recommended in international guidelines, of which 34% were treated for 1 month or less. 18-24 year olds were twice as likely to discontinue treatment within 1 month compared with those aged 40-60 years (aHR:2.03, 95% CI 1.40-2.95). Socioeconomic deprivation was also associated with early treatment discontinuation (aHR:1.40, 95% CI 1.07-1.83). Conclusions: In the year following IBD diagnosis individuals are significantly more likely to start antidepressants compared with controls, but treatment duration fell short of recommendations in the majority. Better integration of services may benefit individuals with IBD and psychiatric comorbidity.

AB - Background: Despite high rates of depression and anxiety, little is known about the use of antidepressants amongst individuals diagnosed with inflammatory bowel disease (IBD). Aims: To evaluate temporal trends in the use of antidepressants; rates of antidepressant initiation and adherence of antidepressant use to international guidelines amongst individuals with IBD. Methods: This is a study of 14,525 incident IBD cases from 2004 to 2016 compared with 58,027 controls matched 1:4 for age and sex from the Clinical Practice Research Datalink. After excluding tricyclic antidepressants, we performed a Cox regression analysis to determine the risk associated with antidepressant use and logistic regression analysis to determine risk associated with antidepressant undertreatment. Results: Antidepressant use amongst individuals with IBD increased by 51% during the 12-year study period, who were 34% more likely to initiate antidepressants in the year after IBD diagnosis compared with controls (aHR:1.34, 95% CI 1.21-1.49). In those with IBD starting antidepressants, 67% received treatment lasting less than the duration recommended in international guidelines, of which 34% were treated for 1 month or less. 18-24 year olds were twice as likely to discontinue treatment within 1 month compared with those aged 40-60 years (aHR:2.03, 95% CI 1.40-2.95). Socioeconomic deprivation was also associated with early treatment discontinuation (aHR:1.40, 95% CI 1.07-1.83). Conclusions: In the year following IBD diagnosis individuals are significantly more likely to start antidepressants compared with controls, but treatment duration fell short of recommendations in the majority. Better integration of services may benefit individuals with IBD and psychiatric comorbidity.

KW - antidepressant medication

KW - antidepressants

KW - anxiety

KW - clinical practice research datalink

KW - Crohn’s disease

KW - depression

KW - incidence

KW - inflammatory bowel disease

KW - ulcerative colitis

UR - http://www.scopus.com/inward/record.url?scp=85127455847&partnerID=8YFLogxK

U2 - 10.1111/apt.16820

DO - 10.1111/apt.16820

M3 - Article

C2 - 35244961

AN - SCOPUS:85127455847

VL - 55

SP - 1330

EP - 1341

JO - Alimentary Pharmacology & Therapeutics

JF - Alimentary Pharmacology & Therapeutics

SN - 0269-2813

IS - 10

ER -