Risk of psychiatric disorders following irritable bowel syndrome: A nationwide population-based cohort study

Yao Tung Lee, Li Yu Hu, Cheng Che Shen, Min Wei Huang, Shih Jen Tsai, Albert C. Yang, Chang Kuo Hu, Chin Lin Perng, Yi Shin Huang, Jeng Hsiu Hung

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder observed in patients who visit general practitioners for GI-related complaints. A high prevalence of psychiatric comorbidities, particularly anxiety and depressive disorders, has been reported in patients with IBS. However, a clear temporal relationship between IBS and psychiatric disorders has not been well established. Objective We explored the relationship between IBS and the subsequent development of psychiatric disorders including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder. Methods We selected patients who were diagnosed with IBS caused by gastroenteritis, according to the data in the Taiwan National Health Insurance Research Database. A comparison cohort was formed of patients without IBS who were matched according to age and sex. The incidence rate and the hazard ratios (HRs) of subsequent new-onset psychiatric disorders were calculated for both cohorts, based on psychiatrist diagnoses. Results The IBS cohort consisted of 4689 patients, and the comparison cohort comprised 18756 matched control patients without IBS. The risks of depressive disorder (HR = 2.71, 95% confidence interval [CI] = 2.30-3.19), anxiety disorder (HR = 2.89, 95% CI = 2.42-3.46), sleep disorder (HR = 2.47, 95% CI = 2.02-3.02), and bipolar disorder (HR = 2.44, 95% CI = 1.34-4.46) were higher in the IBS cohort than in the comparison cohort. In addition, the incidence of newly diagnosed depressive disorder, anxiety disorder, and sleep disorder remained significantly increased in all of the stratified follow-up durations (0-1, 1-5, 5 y). Conclusions IBS may increase the risk of subsequent depressive disorder, anxiety disorder, sleep disorder, and bipolar disorder. The risk ratios are highest for these disorders within 1 year of IBS diagnosis, but the risk remains statistically significant for more than 5 years. Clinicians should pay particular attention to psychiatric comorbidities in IBS patients.

Original languageEnglish
Article numbere0133283
JournalPLoS One
Volume10
Issue number7
DOIs
Publication statusPublished - Jul 29 2015
Externally publishedYes

Fingerprint

behavior disorders
Irritable Bowel Syndrome
cohort studies
Psychiatry
Cohort Studies
Hazards
Population
anxiety
Depressive Disorder
Anxiety Disorders
confidence interval
Bipolar Disorder
Confidence Intervals
Health insurance
irritable bowel syndrome
Comorbidity
health insurance
incidence
general practitioners
Sleep

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Risk of psychiatric disorders following irritable bowel syndrome : A nationwide population-based cohort study. / Lee, Yao Tung; Hu, Li Yu; Shen, Cheng Che; Huang, Min Wei; Tsai, Shih Jen; Yang, Albert C.; Hu, Chang Kuo; Perng, Chin Lin; Huang, Yi Shin; Hung, Jeng Hsiu.

In: PLoS One, Vol. 10, No. 7, e0133283, 29.07.2015.

Research output: Contribution to journalArticle

Lee, YT, Hu, LY, Shen, CC, Huang, MW, Tsai, SJ, Yang, AC, Hu, CK, Perng, CL, Huang, YS & Hung, JH 2015, 'Risk of psychiatric disorders following irritable bowel syndrome: A nationwide population-based cohort study', PLoS One, vol. 10, no. 7, e0133283. https://doi.org/10.1371/journal.pone.0133283
Lee, Yao Tung ; Hu, Li Yu ; Shen, Cheng Che ; Huang, Min Wei ; Tsai, Shih Jen ; Yang, Albert C. ; Hu, Chang Kuo ; Perng, Chin Lin ; Huang, Yi Shin ; Hung, Jeng Hsiu. / Risk of psychiatric disorders following irritable bowel syndrome : A nationwide population-based cohort study. In: PLoS One. 2015 ; Vol. 10, No. 7.
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abstract = "Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder observed in patients who visit general practitioners for GI-related complaints. A high prevalence of psychiatric comorbidities, particularly anxiety and depressive disorders, has been reported in patients with IBS. However, a clear temporal relationship between IBS and psychiatric disorders has not been well established. Objective We explored the relationship between IBS and the subsequent development of psychiatric disorders including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder. Methods We selected patients who were diagnosed with IBS caused by gastroenteritis, according to the data in the Taiwan National Health Insurance Research Database. A comparison cohort was formed of patients without IBS who were matched according to age and sex. The incidence rate and the hazard ratios (HRs) of subsequent new-onset psychiatric disorders were calculated for both cohorts, based on psychiatrist diagnoses. Results The IBS cohort consisted of 4689 patients, and the comparison cohort comprised 18756 matched control patients without IBS. The risks of depressive disorder (HR = 2.71, 95{\%} confidence interval [CI] = 2.30-3.19), anxiety disorder (HR = 2.89, 95{\%} CI = 2.42-3.46), sleep disorder (HR = 2.47, 95{\%} CI = 2.02-3.02), and bipolar disorder (HR = 2.44, 95{\%} CI = 1.34-4.46) were higher in the IBS cohort than in the comparison cohort. In addition, the incidence of newly diagnosed depressive disorder, anxiety disorder, and sleep disorder remained significantly increased in all of the stratified follow-up durations (0-1, 1-5, 5 y). Conclusions IBS may increase the risk of subsequent depressive disorder, anxiety disorder, sleep disorder, and bipolar disorder. The risk ratios are highest for these disorders within 1 year of IBS diagnosis, but the risk remains statistically significant for more than 5 years. Clinicians should pay particular attention to psychiatric comorbidities in IBS patients.",
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AU - Huang, Min Wei

AU - Tsai, Shih Jen

AU - Yang, Albert C.

AU - Hu, Chang Kuo

AU - Perng, Chin Lin

AU - Huang, Yi Shin

AU - Hung, Jeng Hsiu

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