| アブストラクト | BACKGROUND & AIMS: The impact of a temporary or permanent stoma on mental health in Crohn's Disease (CD) is unknown. The aim was 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). CONCLUSIONS: 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. |
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| ジャーナル名 | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association |
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| 投稿日 | 2020/12/29 |
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| 投稿者 | Blackwell, Jonathan; Saxena, Sonia; Jayasooriya, Nishani; Petersen, Irene; Hotopf, Matthew; Creese, Hanna; Bottle, Alex; Pollok, Richard C G |
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| 組織名 | Department of Gastroenterology, St George's University Hospitals NHS Foundation;Trust, London, United Kingdom; St George's University of London (SGUL), Institute;for Infection and Immunity, London, United Kingdom; School of Public Health,;Imperial College London, London, United Kingdom.;School of Public Health, Imperial College London, London, United Kingdom.;Department of Primary Care and Population Health, University College London,;United Kingdom; Department of Clinical Epidemiology, Aarhus University, Aarhus,;Denmark.;Institute of Psychiatry, Psychology and Neuroscience, King's College London,;London, United Kingdom; South London and Maudsley NHS Foundation Trust, London,;United Kingdom.;Imperial College London, London, United Kingdom. Electronic address:;richard.pollok@nhs.net. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33359727/ |
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