Ruth Ann Marrie1, Randy Walld2, James M Bolton3, Jitender Sareen4, John R Walker5, Scott B Patten6, Alexander Singer7, Lisa M Lix8, Carol A Hitchon9, Renée El-Gabalawy10, Alan Katz11, John D Fisk12, Charles N Bernstein13. 1. Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: rmarrie@hsc.mb.ca. 2. Manitoba Centre for Health Policy, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: Randy_walld@cpe.umanitoba.ca. 3. Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: jbolton@hsc.mb.ca. 4. Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: jitender.sareen@umanitoba.ca. 5. Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: john.walker@umanitoba.ca. 6. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada. Electronic address: patten@ucalgary.ca. 7. Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: asinger@sbgh.mb.ca. 8. Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: lisa.lix@umanitoba.ca. 9. Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: carol.hitchon@umanitoba.ca. 10. Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Anesthesia and Perioperative Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: renee.el-gabalawy@umanitoba.ca. 11. Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Manitoba Centre for Health Policy, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: alan_ktaz@cpe.umanitoba.ca. 12. Department of Anesthesia and Perioperative Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, Canada. Electronic address: john.fisk@nshealth.ca. 13. Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: Charles.bernstein@umanitoba.ca.
Abstract
OBJECTIVE: Although psychiatric comorbidity is known to be more prevalent in immune-mediated inflammatory diseases (IMID) than in the general population, the incidence of psychiatric comorbidity in IMID is less understood, yet incidence is more relevant for understanding etiology. METHODS: Using population-based administrative (health) data, we conducted a retrospective cohort study over the period 1989-2012 in Manitoba, Canada. We identified 19,572 incident cases of IMID including 6119 persons with inflammatory bowel disease (IBD), 3514 persons with multiple sclerosis (MS), 10,206 persons with rheumatoid arthritis (RA), and 97,727 age-, sex- and geographically-matched controls. After applying validated case definitions, we estimated the incidence of depression, anxiety disorder, bipolar disorder and schizophrenia in each of the study cohorts. Using negative binomial regression models, we tested whether the incidence rate of psychiatric comorbidity was elevated in the individual and combined IMID cohorts versus the matched cohorts, adjusting for sex, age, region of residence, socioeconomic status and year. RESULTS: The relative incidence of depression (incidence rate ratio [IRR] 1.71; 95%CI: 1.64-1.79), anxiety (IRR 1.34; 95%CI: 1.29-1.40), bipolar disorder (IRR 1.68; 95%CI: 1.52-1.85) and schizophrenia (IRR 1.32; 95%CI: 1.03-1.69) were elevated in the IMID cohort. Depression and anxiety affected the MS population more often than the IBD and RA populations. CONCLUSIONS: Individuals with IMID, including IBD, MS and RA are at increased risk of psychiatric comorbidity. This increased risk appears non-specific as it is seen for all three IMIDs and for all psychiatric disorders studied, implying a common underlying biology for psychiatric comorbidity in those with IMID.
OBJECTIVE: Although psychiatric comorbidity is known to be more prevalent in immune-mediated inflammatory diseases (IMID) than in the general population, the incidence of psychiatric comorbidity in IMID is less understood, yet incidence is more relevant for understanding etiology. METHODS: Using population-based administrative (health) data, we conducted a retrospective cohort study over the period 1989-2012 in Manitoba, Canada. We identified 19,572 incident cases of IMID including 6119 persons with inflammatory bowel disease (IBD), 3514 persons with multiple sclerosis (MS), 10,206 persons with rheumatoid arthritis (RA), and 97,727 age-, sex- and geographically-matched controls. After applying validated case definitions, we estimated the incidence of depression, anxiety disorder, bipolar disorder and schizophrenia in each of the study cohorts. Using negative binomial regression models, we tested whether the incidence rate of psychiatric comorbidity was elevated in the individual and combined IMID cohorts versus the matched cohorts, adjusting for sex, age, region of residence, socioeconomic status and year. RESULTS: The relative incidence of depression (incidence rate ratio [IRR] 1.71; 95%CI: 1.64-1.79), anxiety (IRR 1.34; 95%CI: 1.29-1.40), bipolar disorder (IRR 1.68; 95%CI: 1.52-1.85) and schizophrenia (IRR 1.32; 95%CI: 1.03-1.69) were elevated in the IMID cohort. Depression and anxiety affected the MS population more often than the IBD and RA populations. CONCLUSIONS: Individuals with IMID, including IBD, MS and RA are at increased risk of psychiatric comorbidity. This increased risk appears non-specific as it is seen for all three IMIDs and for all psychiatric disorders studied, implying a common underlying biology for psychiatric comorbidity in those with IMID.
Authors: Charles N Bernstein; Carol A Hitchon; Randy Walld; James M Bolton; Jitender Sareen; John R Walker; Lesley A Graff; Scott B Patten; Alexander Singer; Lisa M Lix; Renée El-Gabalawy; Alan Katz; John D Fisk; Ruth Ann Marrie Journal: Inflamm Bowel Dis Date: 2019-01-10 Impact factor: 5.325
Authors: Charles N Bernstein; Lixia Zhang; Lisa M Lix; Lesley A Graff; John R Walker; John D Fisk; Scott B Patten; Carol A Hitchon; James M Bolton; Jitender Sareen; Renée El-Gabalawy; James Marriott; Ruth Ann Marrie Journal: Inflamm Bowel Dis Date: 2018-08-16 Impact factor: 5.325
Authors: Daniel S Tylee; Yu Kyung Lee; Frank R Wendt; Gita A Pathak; Daniel F Levey; Flavio De Angelis; Joel Gelernter; Renato Polimanti Journal: JAMA Psychiatry Date: 2022-07-01 Impact factor: 25.911
Authors: Daniel S Tylee; Jiayin Sun; Jonathan L Hess; Muhammad A Tahir; Esha Sharma; Rainer Malik; Bradford B Worrall; Andrew J Levine; Jeremy J Martinson; Sergey Nejentsev; Doug Speed; Annegret Fischer; Eric Mick; Brian R Walker; Andrew Crawford; Struan F A Grant; Constantin Polychronakos; Jonathan P Bradfield; Patrick M A Sleiman; Hakon Hakonarson; Eva Ellinghaus; James T Elder; Lam C Tsoi; Richard C Trembath; Jonathan N Barker; Andre Franke; Abbas Dehghan; Stephen V Faraone; Stephen J Glatt Journal: Am J Med Genet B Neuropsychiatr Genet Date: 2018-10-16 Impact factor: 3.568
Authors: Charles N Bernstein; Carol A Hitchon; Randy Walld; James M Bolton; Lisa M Lix; Renée El-Gabalawy; Jitender Sareen; Alexander Singer; Alan Katz; James Marriott; John D Fisk; Scott B Patten; Ruth Ann Marrie Journal: Inflamm Bowel Dis Date: 2021-08-19 Impact factor: 5.325
Authors: Haley A Vecchiarelli; Maria Morena; Catherine M Keenan; Vincent Chiang; Kaitlyn Tan; Min Qiao; Kira Leitl; Alessia Santori; Quentin J Pittman; Keith A Sharkey; Matthew N Hill Journal: Neuropsychopharmacology Date: 2021-01-15 Impact factor: 7.853
Authors: Ruth Ann Marrie; Randy Walld; James M Bolton; Jitender Sareen; John R Walker; Scott B Patten; Alexander Singer; Lisa M Lix; Carol A Hitchon; Renée El-Gabalawy; Alan Katz; John D Fisk; Charles N Bernstein Journal: BMC Res Notes Date: 2017-11-25
Authors: Ruth Ann Marrie; Lesley A Graff; John D Fisk; Scott B Patten; Charles N Bernstein Journal: Inflamm Bowel Dis Date: 2021-07-27 Impact factor: 5.325