Risk of Attempted Suicide Among Patients With IBD: A Nationwide Longitudinal Follow-up Study

BACKGROUND: Evidence suggests that IBD is related to an increased risk of depressive disorder and suicide. OBJECTIVES: Whether IBD is an independent risk factor for suicide remains unclear. DESIGN: A matched cohort study design. SETTINGS: Taiwan National Health Insurance Research Database. PATIENTS: A total of 3625 adults with IBD aged ≥20 years and 36,250 matched controls were selected between 1997 and 2013 and followed-up to the end of 2013. MAIN OUTCOME MEASURES: Any suicide attempt was identified during the study period. Stratified Cox regression analysis was conducted on each matched pair to investigate the attempted suicide risk between the IBD and control groups. RESULTS: The hazard ratio for any suicide attempt among the patients with IBD was 4.61 (95% CI, 3.29-6.48) compared with controls matched exactly for depressive disorder. No significant difference in suicide attempts was noted between patients with ulcerative colitis (HR, 4.12; 95% CI, 2.69-6.32) and patients with Crohn's disease (HR, 5.78; 95% CI, 3.27-10.22). LIMITATIONS: The incidence of any suicide attempt may be underestimated. CONCLUSION: IBD was an independent risk factor for attempted suicide. However, further studies are required to elucidate the definite pathomechanisms between IBD and suicide.