Suicidal Behavior Among Hospitalized Adults With Inflammatory Bowel Disease: A United States Nationwide Analysis.
Background
Suicidal behavior in inflammatory bowel disease (IBD) has been minimally explored. We aimed to determine United States (US) nationally representative prevalence estimates of suicidal ideation (SI) and suicide/self-inflicted injury (S/SII) among hospitalized adults with IBD and to examine trends in suicidal behavior over time.


Methods
A retrospective cross-sectional study using National (Nationwide) Inpatient Sample data (2006-2011) identified adults with Crohn's disease (CD) or ulcerative colitis (UC), SI or S/SII, and multiple comorbid risk factors for suicidal behavior.


Results
We identified 331,777 (estimated 1.64 million) IBD-related hospitalizations (64% CD, 36% UC) and 39,787,239 (estimated 196.08 million) hospitalizations among the general US population. Among IBD-related hospitalizations, 2502 discharges were associated with SI (prevalence 0.76%) and 1104 with S/SII (prevalence 0.33%). Both were significantly greater in CD versus UC (P < 0.001). Relative to the general US population, IBD patients were significantly less likely to demonstrate suicidal behavior: (SI:0.33% versus 0.59%, P < 0.001) (S/SII:0.75% versus 1.04%, P < 0.001). Multivariable logistic regression revealed that IBD was associated with decreased odds of SI (adjusted odds ratio [aOR] 0.62, 95%CI 0.60-0.65) and S/SII (aOR 0.43, 95%CI 0.40-0.45) relative to the general population, and suicidal behavior was lower in IBD compared to disease-related controls with rheumatoid arthritis and systemic lupus erythematosus. Similar increasing trends in suicidal behavior were observed in IBD and non-IBD populations (2006-2011).


Conclusion
In this large US database, SI or S/SII occurred in over 1% of the IBD population and was increased in CD versus UC.
['Marchioni Beery|Renée M|RM|', 'Barnes|Edward L|EL|', 'Nadkarni|Ashwini|A|', 'Korzenik|Joshua R|JR|']
D000293:Adolescent D000328:Adult D001172:Arthritis, Rheumatoid D016022:Case-Control Studies D003430:Cross-Sectional Studies D005260:Female D006760:Hospitalization D006801:Humans D015212:Inflammatory Bowel Diseases D008180:Lupus Erythematosus, Systemic D008297:Male D008875:Middle Aged D011379:Prognosis D012189:Retrospective Studies D059020:Suicidal Ideation D013405:Suicide D014481:United States D055815:Young Adult
suicide self-inflicted injury inflammatory bowel diseases/psychology mental health