Pediatric Onset of Immune-Mediated Inflammatory Diseases Associated With Increased Rates of Certain Psychiatric Disorders

Investigators assessed rates of psychiatric comorbidities and suicide, as well as their risk factors, in patients with childhood-onset immune-mediated inflammatory diseases.

Patients with childhood-onset immune-mediated inflammatory diseases (IMID) have an increased prevalence of anxiety and mood disorders compared with control individuals, according to research presented at the Advances in Inflammatory Bowel Diseases (AIBD) 2021 Annual Meeting, held from December 9 to 11, 2021, in Orlando, Florida and virtually.

Researchers conducted a systematic review of studies on psychiatric comorbidities, suicide rates, and their potential risk factors among patients with childhood-onset IMID.

The investigators searched the Pubmed, PsychINFO, and Embase databases for studies regarding pediatric-onset inflammatory bowel disease (pIBD), rheumatic diseases (RD), and autoimmune liver diseases. The studies that reported prevalence rates of diagnosed psychiatric disorders and/or suicide were included in the review.

Random-effects meta-analysis was used to calculate the pooled prevalence rates of psychiatric disorders reported by 3 or more studies within the same IMID. Psychiatric disorders were grouped according to International Classification of Diseases-10th Revision. The risk for bias was assessed independently by 2 authors with use of the New-Castle Ottawa scale.

A total of 23 studies were included in the review — 13 regarding psychiatric disorders in pIBD and 10 in RD. No studies reported on psychiatric disorders in autoimmune liver diseases.

Patients with IMID had an increased risk for psychiatric disorders, with anxiety and mood disorders being the most common, compared with control individuals without somatic disease.

Among patients with pIBD, the prevalence rates for anxiety and mood disorders were 6% (95% CI, 4%-9%) and 4% (95% CI, 2%-8%), respectively, in register-based studies, and 33% (95% CI, 25%-41%) and 18% (95% CI, 12%-26%), respectively, in studies that used psychiatric assessment.

The pooled estimates for RD were 13% (95% CI, 12%-15%) for anxiety disorders and 20% (95% CI, 15%-26%) for mood disorders. Suicide risk was increased in pIBD, but not in juvenile idiopathic arthritis, the most common RD, according to analysis of single studies.

The study authors noted that only pooled estimates on emotional disorders were possible and that studies on a wider variety of psychiatric disorders are needed.


Sabine J, Mikkel M, Vibeke W, et al. Psychiatric comorbidity and suicide in childhood onset immune-mediated diseases—a systematic review and meta-analysis. Presented at: AIBD 2021 Annual Meeting; December 9-11, 2021; Orlando, FL and virtual. Abstract P002.

This article originally appeared on Gastroenterology Advisor