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Increased suicide risk in coeliac disease--a Swedish nationwide cohort study.

Abstract

BACKGROUND AND AIM

Individuals with coeliac disease have increased risk of depression and death from external causes, but conclusive studies on death from suicide are missing. We examined the risk of suicide in coeliac disease and amongst individuals where the small intestinal biopsy showed no villous atrophy.

METHODS

We collected biopsy data from all 28 clinical pathology departments in Sweden for individuals diagnosed during 1969-2007 with coeliac disease (Marsh 3: villous atrophy; n=29,083 unique individuals), inflammation without villous atrophy (Marsh 1-2; n=13,263) or positive coeliac disease serology but normal mucosa (Marsh 0, n=3719). Through Cox regression we calculated Hazard ratios for suicide as recorded in the Swedish Cause of Death Register.

RESULTS

The risk for suicide was higher in patients with coeliac disease compared to general population controls (HR=1.55; 95%CI=1.15-2.10; based on 54 completed suicides). Whilst suicide was also more common amongst individuals with inflammation (HR=1.96; 95%CI=1.39-2.77), no such increase was seen amongst individuals with a normal mucosa but positive coeliac disease serology (HR=1.06; 95%CI=0.37-3.02).

CONCLUSIONS

We found a moderately increased risk of suicide amongst patients with coeliac disease. This merits increased attention amongst physicians treating these patients.

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  • Authors+Show Affiliations

    ,

    Department of Paediatrics, Örebro University Hospital, Sweden. jonasludvigsson@yahoo.com

    , , ,

    Source

    MeSH

    Adolescent
    Adult
    Anxiety Disorders
    Celiac Disease
    Child
    Child, Preschool
    Depressive Disorder
    Female
    Humans
    Infant
    Inflammation
    Male
    Middle Aged
    Proportional Hazards Models
    Suicide
    Sweden
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    21419726

    Citation

    Ludvigsson, Jonas F., et al. "Increased Suicide Risk in Coeliac Disease--a Swedish Nationwide Cohort Study." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 43, no. 8, 2011, pp. 616-22.
    Ludvigsson JF, Sellgren C, Runeson B, et al. Increased suicide risk in coeliac disease--a Swedish nationwide cohort study. Dig Liver Dis. 2011;43(8):616-22.
    Ludvigsson, J. F., Sellgren, C., Runeson, B., Långström, N., & Lichtenstein, P. (2011). Increased suicide risk in coeliac disease--a Swedish nationwide cohort study. Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 43(8), pp. 616-22. doi:10.1016/j.dld.2011.02.009.
    Ludvigsson JF, et al. Increased Suicide Risk in Coeliac Disease--a Swedish Nationwide Cohort Study. Dig Liver Dis. 2011;43(8):616-22. PubMed PMID: 21419726.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Increased suicide risk in coeliac disease--a Swedish nationwide cohort study. AU - Ludvigsson,Jonas F, AU - Sellgren,Carl, AU - Runeson,Bo, AU - Långström,Niklas, AU - Lichtenstein,Paul, Y1 - 2011/03/17/ PY - 2010/11/25/received PY - 2011/01/17/revised PY - 2011/02/04/accepted PY - 2011/3/23/entrez PY - 2011/3/23/pubmed PY - 2011/12/30/medline SP - 616 EP - 22 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 43 IS - 8 N2 - BACKGROUND AND AIM: Individuals with coeliac disease have increased risk of depression and death from external causes, but conclusive studies on death from suicide are missing. We examined the risk of suicide in coeliac disease and amongst individuals where the small intestinal biopsy showed no villous atrophy. METHODS: We collected biopsy data from all 28 clinical pathology departments in Sweden for individuals diagnosed during 1969-2007 with coeliac disease (Marsh 3: villous atrophy; n=29,083 unique individuals), inflammation without villous atrophy (Marsh 1-2; n=13,263) or positive coeliac disease serology but normal mucosa (Marsh 0, n=3719). Through Cox regression we calculated Hazard ratios for suicide as recorded in the Swedish Cause of Death Register. RESULTS: The risk for suicide was higher in patients with coeliac disease compared to general population controls (HR=1.55; 95%CI=1.15-2.10; based on 54 completed suicides). Whilst suicide was also more common amongst individuals with inflammation (HR=1.96; 95%CI=1.39-2.77), no such increase was seen amongst individuals with a normal mucosa but positive coeliac disease serology (HR=1.06; 95%CI=0.37-3.02). CONCLUSIONS: We found a moderately increased risk of suicide amongst patients with coeliac disease. This merits increased attention amongst physicians treating these patients. SN - 1878-3562 UR - https://www.unboundmedicine.com/medline/citation/21419726/Increased_suicide_risk_in_coeliac_disease__a_Swedish_nationwide_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(11)00058-2 DB - PRIME DP - Unbound Medicine ER -