INTRODUCTION Inflammatory bowel disease (IBD) is associated with depression and anxiety in adults, but data is scarce on risk of psychiatric diseases in children with IBD. We aimed to estimate the risk of anxiety, depression, or attention-deficit/hyperactivity disorder in patients with pediatric-onset IBD. METHODS We performed a nationwide, register-based cohort study including all patients with pediatric-onset IBD diagnosed in Denmark in the period 1998-2018, resulting in 3,559 patients matched 1:5 on age, sex, municipality of residence, and time period, resulting in 17,795 reference individuals. We used Cox regression to calculate hazard ratios for each outcome following a diagnosis with IBD. RESULTS Patients with pediatric-onset IBD had an increased risk of depression (hazard ratio [HR] 1.50, 95% confidence interval [CI] 1.26-1.80) and of using antidepressants (HR 1.54, 95% CI 1.39-1.71), and surprisingly a reduced risk of using methylphenidate (HR 0.75, 95% CI 0.58-0.98). Patients with both IBD subtypes (Crohn's diseases [CD] and ulcerative colitis [UC]) had an increased risk of using antidepressants and developing depression, which was particularly high in patients with CD (HR 1.73, 95% CI 1.35-2.22). Patients with UC had reduced risk of using methylphenidate (HR 0.63, 95% CI 0.43-0.93) and a reduced - though not statistically significant - risk of being diagnosed with ADHD compared with the background population. DISCUSSION Patients with pediatric-onset IBD have a 50% increased risk of developing depression, which is important for health care providers to be aware of and manage. Remarkably, we found a reduced risk of receiving methylphenidate and being diagnosed with ADHD, which merits further investigation.

中文翻译：

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炎症性肠病儿科患者的焦虑、抑郁和多动症风险：一项基于人群的队列研究。

简介 炎症性肠病 (IBD) 与成人抑郁和焦虑有关，但有关 IBD 儿童患精神疾病风险的数据很少。我们的目的是评估儿童发病的 IBD 患者出现焦虑、抑郁或注意力缺陷/多动障碍的风险。方法 我们进行了一项全国性的、基于登记的队列研究，包括 1998 年至 2018 年期间在丹麦诊断的所有儿科发病 IBD 患者，结果 3,559 名患者在年龄、性别、居住城市和时间段上进行了 1:5 匹配。得出 17,795 个参考个体。我们使用 Cox 回归来计算 IBD 诊断后每个结果的风险比。结果 儿科发病的 IBD 患者患抑郁症的风险增加（风险比 [HR] 1.50，95% 置信区间 [CI] 1.26-1.80），使用抗抑郁药物的风险增加（HR 1.54，95% CI 1.39-1.71），令人惊讶的是使用哌醋甲酯的风险降低（HR 0.75，95% CI 0.58-0.98）。患有两种 IBD 亚型（克罗恩病 [CD] 和溃疡性结肠炎 [UC]）的患者使用抗抑郁药和患抑郁症的风险增加，其中 CD 患者的风险尤其高（HR 1.73，95% CI 1.35-2.22）。与背景人群相比，UC 患者使用哌甲酯的风险降低（HR 0.63，95% CI 0.43-0.93），并且被诊断为 ADHD 的风险降低（尽管不具有统计学意义）。讨论 儿科发病的 IBD 患者患抑郁症的风险增加 50%，这对于医疗保健提供者来说很重要。值得注意的是，我们发现接受哌醋甲酯和被诊断为多动症的风险降低了，这值得进一步研究。