Risk of Mental Health Conditions in Children and Young Adults With Inflammatory Bowel Disease and Influence on Health

Completed

Conditions: Recurrent Depressive Disorder
Self Harm
Attention Deficit Hyperactivity Disorder
Schizophrenia
Parasuicide
Inflammatory Bowel Diseases
Depressive Episode
Anxiety Disorder
Psychological Disorder
Behavioral Disorder

Brief Summary: This study is a large population-based analysis in the United Kingdom (UK) using routine primary care data to investigate the impacts on quality-of-life outcomes and use of healthcare services in people aged 5 - 25 years diagnosed with Inflammatory Bowel Disease (IBD) and the impacts of mental health conditions in those diagnosed with IBD.

Detailed Description: This study will use routinely electronic medical record (EMR) data from primary care practices within the Optimum Patient Care Research Database (OPCRD).

Stream 1 primary objective is to compare the prevalence and cumulative incidence of mental health conditions in children, adolescents and young adults (aged 5-25 years) with a diagnosis of Inflammatory Bowel Disease (IBD), compared to matched population controls without a diagnosis of IBD. The secondary objective is to determine the severity of mental health outcomes in those with and without a diagnosis of IBD.

Stream 2 primary objective is to determine the impact of mental health conditions in children, adolescents and young adults (aged 5-25 years) diagnosed with IBD on quality-of-life indicators, such as records for absence from work or school, unemployment, sleep disturbance and substance abuse.

The secondary objectives are to compare indicators of IBD severity, such as medication use, surgical intervention, nutritional supplement prescriptions and markers of nutritional status including underweight or growth retardation,and healthcare resource utilisation.These impacts and indicators will be assessed using participants that have been diagnosed with IBD, comparing those with the presence of a mental health condition to those without a mental health condition.

Recruitment & Eligibility

Inclusion Criteria

Aged between 5 years and 25 years
Registration with a general practices (GP) contributing routinely collected electronic healthcare data to the Optimum Patient Care Research Database (OPCRD) for more than 6 months during the follow up period
A recorded diagnosis of IBD in the clinical record (cases)

Exclusion Criteria

• None

Primary Outcome Measures

Name	Time	Method
Stream 1: Percentage of Participants Who Developed Any Mental Health Condition	5 years	Cumulative incidence (percentage of participants in each arm who developed any mental health condition) was calculated using Kaplan-Meier analysis
Stream 1: Relative Risk of Any Mental Health Condition	Retrospective data assessed from 2010-2020, up to 10 years	Calculated using Cox proportional hazards models using matched controls as the reference group. Adjusted for age, sex, socioeconomic status, ethnicity, and other common chronic childhood conditions.
Stream 2: Relative Risk of Bowel Symptoms (Quality of Life Indicator)	5 years of follow-up.	Bowel symptoms consist of abdominal pain, bloating, discomfort and diarrhoea. Relative risk in participants with mental health conditions compared with those without mental health (MH) conditions. Calculated using negative binomial regression.
Stream 2: Relative Risk of Sleep Disturbance (Quality of Life Indicator)	5 years of follow-up.	Relative risk in participants with mental health conditions compared with those without MH conditions. Calculated using Cox regression.
Stream 2: Relative Risk of Low Mood (Emotional Function)	5 years of follow-up.	Relative risk in participants with mental health conditions compared with those without MH conditions. Calculated using negative binomial regression.

Secondary Outcome Measures

Name	Time	Method
Stream 1: Lifetime Risk of Developing a Mental Health Condition	Retrospective data assessed from 2010-2020, up to 10 years	Probability of developing a mental health condition by age 25 years.Estimated using modified Cox regression models
Stream 2: Relative Risk of Increased Primary Care Utilisation	5 years of follow-up.	Relative risk of increased primary care visits in participants with mental health conditions compared with those without MH conditions. Calculated using negative binomial regression.
Stream 2: Relative Risk of Increased Hospital Admissions	5 years of follow-up.	Relative risk of increased hospital admissions in participants with mental health conditions compared with those without MH conditions. Calculated using negative binomial regression.