TABLE 4.
Predictors of incident depression, anxiety and ADM use amongst the IBD population
| Depression | Anxiety | ADM | ||||
|---|---|---|---|---|---|---|
| Unadjusted HR (95% CI) | Adjusted HR (95% CI; P value) | Unadjusted HR (95% CI) | Adjusted HR (95% CI; P value) | Unadjusted HR (95% CI) | Adjusted HR (95% CI; P value) | |
| IBD cohort | ||||||
| UC | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
| CD | 1.29 (1.16‐1.44) | 1.10 (0.98‐1.24; 0.116) | 1.15 (1.02‐1.29) | 1.04 (0.91‐1.17; 0.570) | 1.19 (1.08‐1.32) | 1.05 (0.95‐1.17; 0.299) |
| Sex | ||||||
| Male | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
| Female | 1.54 (1.39 ‐1.71) | 1.51 (1.36‐1.68; 0.000) | 1.53 (1.37‐1.71) | 1.52 (1.36‐1.70; 0.000) | 1.34 (1.22‐1.47) | 1.31 (1.19‐1.43; 0.000) |
| Age at diagnosis (year) | ||||||
| <18 | 0.93 (0.73‐1.19) | 1.21 (0.94‐1.56; 0.140) | 0.88 (0.67‐1.15) | 0.98 (0.74‐1.31; 0.916) | 0.55 (0.42‐0.73) | 0.68 (0.51‐0.90; 0.007) |
| 18‐25 | 1.76 (1.49‐2.08) | 1.80 (1.49‐2.16; 0.000) | 1.61 (1.34‐1.94) | 1.69 (1.37‐2.07; 0.000) | 1.79 (1.54‐2.08) | 1.78 (1.50‐2.09; 0.000) |
| 25‐40 | 1.28 (1.1‐1.46) | 1.27 (1.11‐1.45; 0.000) | 1.40 (1.21‐1.61) | 1.39 (1.21‐1.60; 0.000) | 1.40 (1.24‐1.57) | 1.38 (1.23‐1.55; 0.000) |
| 40‐60 | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
| ≥60 | 0.78 (0.68‐0.91) | 0.81 (0.70‐0.93; 0.004) | 0.78 (0.68‐0.89) | 0.79 (0.67‐0.92; 0.003) | 0.89 (0.79‐1.01) | 0.92 (0.81‐1.04; 0.192) |
| Social deprivation | ||||||
| IMD 1‐3** | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
| IMD 4‐5 | 1.18 (1.02‐1.36) | 1.10 (0.95‐1.27; 0.200) | 1.04 (0.88‐1.22) | 0.98 (0.85‐1.17; 0.845) | 1.18 (1.03‐1.34) | 1.09 (0.97‐1.21; 0.179) |
| Unknown | 1.02 (0.91‐1.15) | 0.99 (0.88‐1.11; 0.850) | 1.21 (1.06‐1.36) | 1.18 (1.04‐1.34; 0.008) | 1.07 (0.97‐1.19) | 1.01 (0.91‐1.12; 0.926) |
| Era of IBD diagnosis | ||||||
| Era 1: 2004‐2007 | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
| Era 2: 2008‐2011 | 0.91 (0.81‐1.02) | 0.88 (0.84‐1.31; 0.143) | 0.98 (0.86‐1.12) | 0.97 (0.85‐1.10; 0.652) | 1.11 (0.99‐1.24) | 1.11 (0.99‐1.24; 0.140) |
| Era 3: 2012‐2015 | 0.99 (0.86‐1.15) | 0.97 (0.76‐1.25; 0.644) | 1.22 (1.05‐1.42) | 1.19 (1.01‐1.38; 0.026) | 1.56 (1.36‐1.75) | 1.51 (1.33‐1.71; 0.000) |
| Smoking status | ||||||
| Never | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
| Smoker | 1.54 (1.34‐1.78) | 1.47 (1.27‐1.71; 0.000) | 1.25 (1.05‐1.48) | 1.21 (1.02‐1.44; 0.029) | 1.45 (1.28‐1.66) | 1.44 (1.26‐1.65; 0.000) |
| Ex‐smoker | 0.94 (0.82‐1.08) | 1.12 (0.96‐1.27; 0.116) | 1.01 (0.88‐1.17) | 1.19 (1.02‐1.37; 0.024) | 0.96 (0.85‐1.08) | 1.06 (1.02‐1.27; 0.523) |
| Missing | 0.74 (0.64‐0.87) | 0.77 (0.66‐0.90; 0.002) | 0.92 (0.79‐1.08) | 0.99 (0.84‐1.17; 0.913) | 0.69 (0.60‐0.79) | 0.78 (0.68‐0.90; 0.001) |
| Corticosteroid use | 0.98 (0.77‐1.24) | 1.03 (0.81‐1.31; 0.747) | 0.84 (0.66‐1.07) | 0.88 (0.69‐1.12; 0.289) | 0.86 (0.70‐1.05) | 0.90 (0.74‐1.10; 0.349) |
*All covariates in the table were included within the adjusted analysis. Abbreviations: *HR, Hazard ratio; *CI, confidence interval; *IBD, inflammatory bowel disease; *CD, Crohn’s disease *UC, ulcerative colitis; *Depression, depression diagnostic and/or depressive symptom code; *Anxiety, anxiety diagnostic and/or anxiety symptom code; *ADM, antidepressant medication; *IMD, Index of Multiple Deprivation; IMD 1 represents the least deprived and IMD 5 the most deprived. IMD data are available only for individual’s resident in England.
Bold values indicate statistical significance.