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Stoma formation in Crohn's Disease and the likelihood of antidepressant use: a population-based cohort study.

Blackwell, J; Saxena, S; Jayasooriya, N; Petersen, I; Hotopf, M; Creese, H; Bottle, A; Pollok, RCG; POP-IBD study group (2022) Stoma formation in Crohn's Disease and the likelihood of antidepressant use: a population-based cohort study. Clin Gastroenterol Hepatol, 20 (4). e703-e710. ISSN 1542-7714 https://doi.org/10.1016/j.cgh.2020.12.026
SGUL Authors: Pollok, Richard Charles G

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Abstract

BACKGROUND AND AIMS: The impact of a temporary or permanent stoma on mental health in Crohn's Disease (CD) is unknown. AIM: 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). CONCLUSION: 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.

Item Type: Article
Additional Information: © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Crohn's Disease, Inflammatory Bowel Disease, Psychological Stress, Psychosomatic Medicine, Ulcerative Colitis, antidepressants, depression, Gastroenterology & Hepatology, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Clin Gastroenterol Hepatol
ISSN: 1542-7714
Language: eng
Dates:
DateEvent
11 March 2022Published
25 December 2020Published Online
18 December 2020Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Projects:
Project IDFunderFunder ID
SP2018/3Crohn's and Colitis UKhttp://dx.doi.org/10.13039/501100003522
UNSPECIFIEDWellcome Trusthttp://dx.doi.org/10.13039/100004440
UNSPECIFIEDNational Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
PubMed ID: 33359727
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112740
Publisher's version: https://doi.org/10.1016/j.cgh.2020.12.026

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