PMID- 30337374 OWN - NLM STAT- MEDLINE DCOM- 20190924 LR - 20190925 IS - 1468-3288 (Electronic) IS - 0017-5749 (Linking) VI - 68 IP - 9 DP - 2019 Sep TI - Depression increases the risk of inflammatory bowel disease, which may be mitigated by the use of antidepressants in the treatment of depression. PG - 1606-1612 LID - 10.1136/gutjnl-2018-317182 [doi] AB - OBJECTIVE: Depression is associated with IBD, but the effect of antidepressants on IBD has been sparsely studied. We assessed the impact of depression and antidepressant therapies on the development of IBD. DESIGN: The Health Improvement Network (THIN) was used to identify a cohort of patients with new-onset depression from 1986 to 2012. THIN patients who did not meet the defining criteria for depression were part of the referent group. The outcome was incident Crohn's disease (CD) or ulcerative colitis (UC). Cox proportional hazards modelling was performed to evaluate the rate of Crohn's disease or UC development among patients with an exposure of depression after controlling for age, sex, socioeconomic status, comorbid conditions, smoking, anxiety and antidepressant use including atypical antidepressants, mirtazapine, monoamine oxidase inhibitors (MAOI), serotonin norepinephrine reuptake inhibitors (SNRI), selective serotonin reuptake inhibitors (SSRI), serotonin modulators; and tricyclic antidepressants (TCA). RESULTS: We identified 403 665 (7.05%) patients with incident depression. Individuals with depression had a significantly greater risk of developing CD (adjusted HR=2.11, 95% CI 1.65 to 2.70) and UC (adjusted HR=2.23, 95% CI 1.92 to 2.60) after controlling for demographic and clinical covariates. SSRI and TCA were protective against CD, whereas mirtazapine, SNRI, SSRI, serotonin modulators and TCA were protective for UC. CONCLUSION: Patients with a history of depression were more likely to be diagnosed with IBD. In contrast, antidepressant treatments were selectively protective for Crohn's disease and UC. These results may impact counselling and management of depression and IBD. CI - (c) Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Frolkis, Alexandra D AU - Frolkis AD AD - Department of Medicine, University of Calgary, Calgary, Alberta, Canada. AD - Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. FAU - Vallerand, Isabelle A AU - Vallerand IA AD - Department of Medicine, University of Calgary, Calgary, Alberta, Canada. AD - Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. FAU - Shaheen, Abdel-Aziz AU - Shaheen AA AD - Department of Medicine, University of Calgary, Calgary, Alberta, Canada. AD - Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. FAU - Lowerison, Mark W AU - Lowerison MW AD - Department of Medicine, University of Calgary, Calgary, Alberta, Canada. AD - Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. AD - Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. FAU - Swain, Mark G AU - Swain MG AD - Department of Medicine, University of Calgary, Calgary, Alberta, Canada. FAU - Barnabe, Cheryl AU - Barnabe C AD - Department of Medicine, University of Calgary, Calgary, Alberta, Canada. AD - Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. FAU - Patten, Scott B AU - Patten SB AD - Department of Medicine, University of Calgary, Calgary, Alberta, Canada. AD - Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. FAU - Kaplan, Gilaad G AU - Kaplan GG AUID- ORCID: 0000-0003-2719-0556 AD - Department of Medicine, University of Calgary, Calgary, Alberta, Canada. AD - Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. LA - eng GR - THC -135231/CIHR/Canada PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20181018 PL - England TA - Gut JT - Gut JID - 2985108R RN - 0 (Antidepressive Agents) SB - IM CIN - Gut. 2020 Mar;69(3):606-607. PMID: 30760487 CIN - Gut. 2020 Mar;69(3):607. PMID: 30792245 CIN - Gut. 2020 Mar;69(3):609-610. PMID: 30808645 CIN - Gut. 2020 Mar;69(3):611-612. PMID: 30894399 MH - Adolescent MH - Adult MH - Aged MH - Antidepressive Agents/*therapeutic use MH - Colitis, Ulcerative/epidemiology/etiology/prevention & control MH - Comorbidity MH - Crohn Disease/epidemiology/etiology/prevention & control MH - Depression/*complications/drug therapy/epidemiology MH - Female MH - Follow-Up Studies MH - Humans MH - Inflammatory Bowel Diseases/epidemiology/*etiology/prevention & control MH - Male MH - Middle Aged MH - Retrospective Studies MH - Risk Assessment/methods MH - Social Class MH - United Kingdom/epidemiology MH - Young Adult OTO - NOTNLM OT - Crohn's disease OT - epidemiology OT - inflammatory bowel disease OT - ulcerative colitis COIS- Competing interests: MGS, AAS and GGK share a patent: TREATMENT OF INFLAMMATORY DISORDERS, AUTOIMMUNE DISEASE, AND PBC. UTI Limited Partnership, assignee. Patent 62/555,397. 7 September 2017. GGK has served as a speaker for Janssen, AbbVie and Pfizer, and has received research support from Janssen, AbbVie, GlaxoSmithKline and Shire. EDAT- 2018/10/20 06:00 MHDA- 2019/09/26 06:00 CRDT- 2018/10/20 06:00 PHST- 2018/07/21 00:00 [received] PHST- 2018/09/08 00:00 [revised] PHST- 2018/09/14 00:00 [accepted] PHST- 2018/10/20 06:00 [pubmed] PHST- 2019/09/26 06:00 [medline] PHST- 2018/10/20 06:00 [entrez] AID - gutjnl-2018-317182 [pii] AID - 10.1136/gutjnl-2018-317182 [doi] PST - ppublish SO - Gut. 2019 Sep;68(9):1606-1612. doi: 10.1136/gutjnl-2018-317182. Epub 2018 Oct 18.