Abstract

Physical comorbidities increase the risk of psychiatric comorbidity in immune-mediated inflammatory disease

Marrie RA1, Walld R2, Bolton JM3, Sareen J3, Walker JR4, Patten SB5, Singer A6, Lix LM7, Hitchon CA8, El-Gabalawy R9, Katz A10, Fisk JD11, Bernstein CN8; CIHR Team in Defining the Burden and Managing the Effects of Psychiatric Comorbidity in Chronic Immunoinflammatory Disease. Gen Hosp Psychiatry. 2018 Jan 11;51:71-78. doi: 10.1016/j.genhosppsych.2018.01.003. [Epub ahead of print]
 
     

Author information

1 Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: rmarrie@hsc.mb.ca.

2 Manitoba Centre for Health Policy, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

3 Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

4 Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

5 Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.

6 Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

7 Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

8 Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

9 Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Anesthesia and Perioperative Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

10 Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Manitoba Centre for Health Policy, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

11 Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, Canada.

Abstract

OBJECTIVE: We tested the association between physical comorbidity and incident depression, anxiety disorder and bipolar disorder in three immune-mediated inflammatory diseases (IMID): inflammatory bowel disease(IBD), multiple sclerosis (MS) and rheumatoid arthritis (RA) versus age-, sex- and geographically-matched controls.

METHODS: Using population-based administrative data we identified 6119 persons with IBD, 3514 persons with MS, 10,206 persons with RA and 97,727 matched controls. We identified incident cases of depression, anxiety disorder and bipolar disorder in these populations. We evaluated the association of physical comorbidities with incident psychiatric comorbidity using Cox regression, adjusting for sociodemographic factors and index year.

RESULTS: The risk of incident depression, anxiety disorders and bipolar disorder was higher in each IMID cohort versus their matched cohorts. The risk of incident psychiatric comorbidity increased with an increasing number of physical comorbidities for each psychiatric comorbidity evaluated, across all IMID. Adjustment for physical comorbidity did not attenuate the increased risk of psychiatric comorbidity in the IMID cohorts versus their matched cohorts.

CONCLUSION: The increased incidence of psychiatric comorbidity in IMID versus matched general population cohorts is not accounted for by their increased prevalence of physical comorbidities. However, within IMID cohorts, physical comorbidity increases the risk of psychiatric comorbidity.

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