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Journal Article Ahead of print 1 citation

PubMed: 41401386 DOI: 10.1097/MCG.0000000000002308

Suicide Attempts, Schizophrenia, and Depression Among Inflammatory Bowel Disease Patients: Data From a Large Database.

J Clin Gastroenterol

Authors: Vered Richter, Nechama Markovitz, Yoav Krupik, Noa Menkes-Caspi, Yarden Itzhaky, Daniel L Cohen, Haim Shirin, Roba Ganayem, Naim Abu-Freha

Affiliations

  • The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv.
  • Data Research Center for Mental Health and Rehabilitation, Geha Mental Health Center, Petah Tikva.
  • Faculty of Health Sciences, Ben-Gurion University of the Negev; Israel.
  • Institute of Gastroenterology and Hepatology, Soroka University Medical Center.
  • Institute of Gastroenterology and Hepatology, Clalit Health Services, Southern District, Beer-Sheva, Israel.

Abstract

BACKGROUND AND AIMS

Psychiatric disorders are more common in inflammatory bowel disease (IBD) patients compared with the general population. We aimed to investigate the prevalence and risk factors of depression, schizophrenia, and suicide attempts among IBD patients in Israel.

METHODS

Data on IBD patients over 25 years (1999 to 2024) was extracted from the Clalit Health Maintenance Organization. Possible risk factors were investigated via multivariate analyses. A matched case-control analysis was performed of attempted suicide cases.

RESULTS

A total of 3,262,623 adults were analyzed. The frequency rate of suicide attempts was 1.5%, schizophrenia 1.3%, and depression 25.7% among 19,100 Crohn's disease (CD) patients compared with 1.1%, 1.4%, and 23.0% among 17,731 ulcerative colitis (UC) patients. In a multivariate analysis, female gender (OR 1.284, P<0.001), smoking (OR 1.479, P<0.001), CD (OR 1.274, P<0.010), schizophrenia (OR 7.69, P<0.001), and depression (OR 6.284, P<0.001) were found to be predictors of suicide attempts. Case-control analysis of 490 patients with a prior suicide attempt revealed significantly higher rates of schizophrenia (13.1% vs. 1.2%, P<0.001) and depression (70.0% vs. 19.6%, P<0.001) among the suicide group. In a multivariate analysis, schizophrenia (OR 9.873, P<0.001) and depression (OR 8.964, P<0.001) were significant risk factors for suicide attempts. The mortality rate among those with a suicide attempt (98/490, 20%) was significantly higher compared with those without a suicide attempt (5301/36,341, 14.6%, P<0.001).

CONCLUSION

The main risk factor for suicide attempts among IBD patients is comorbid psychiatric disease. Proactive mental health care by gastroenterologists and integrated psychology services is highly recommended.

MeSH

Depression, Gastroenterology, Mental Disorders, Schizophrenia, Inflammatory Bowel Diseases, Multivariate Analysis, Risk Factors, Suicide, Attempted, Suicide