P884 Association between psychosocial factors experienced in childhood or adolescence and occurrence of Inflammatory Bowel Disease (IBD) in adulthood: a case-control study in Quebec, Canada
Esmingeaud, L.(1)*;Jantchou, P.(2);Nicolau, B.(3);Madathil, S.(3);Rousseau, M.C.(1);
(1)Armand-Frappier Health Biotechnology Center- Institut national de la recherche scientifique INRS, Epidemiology and Biostatistics Unit, Laval, Canada;(2)CHU Sainte-Justine, Department of Gastroenterology- Research Center, Montreal, Canada;(3)McGill University, Faculty of Dental Medicine and Oral Health Sciences, Montreal, Canada;
The incidence of inflammatory bowel disease (IBD) has been steadily increasing worldwide and its etiology remains poorly understood. This study aims to estimate the associations between exposure to psychosocial factors in childhood or adolescence and the development of IBD in adulthood, separately for Crohn's disease and ulcerative colitis.
A case-control study nested in a population-based birth cohort was carried out. A total of 993 cases of Crohn's disease, 489 cases of ulcerative colitis and 914 controls born between 1970 and 1974 in Quebec, Canada, were analyzed. Sociodemographic and medical information were extracted from administrative databases. Participants filled out a questionnaire including a section on selected psychosocial factors experienced over their life course. Odds ratios (OR) and confidence intervals (95% CI) for the associations between psychosocial factors in childhood (0-9 years), adolescence (10-17 years) or over the full pediatric period (0-17 years), and IBD in adulthood were estimated by unconditional logistic regression models adjusted for potential confounding factors. For each association, a model including tailored covariates selected with a directed acyclic graph was estimated. The number of psychosocial factors experienced over the pediatric period was also analyzed in relation to the risk of IBD in adulthood.
Some factors were associated with the risk of Crohn’s disease, such as sexual abuse in childhood (OR=1.58; 95% CI: 1.08-2.30) or over the full pediatric period (OR=1.39; 95% CI: 1.04-1.84). Likewise, the following factors occurring during adolescence were associated with increased odds of Crohn’s disease: parental neglect (OR=1.64; 95% CI: 1.01-2.66), the death of a loved one (OR=1.37; 95% CI: 1.02-1.85), and anxiety disorders (OR=1.66; 95% CI: 1.02-2.70). An association was identified between the experience of anxiety disorders from 0 to 17 years and ulcerative colitis in adulthood (OR=1.67; 95% CI: 1.05-2.67). Finally, exposure to three or more (vs. none) psychosocial factors from 0 to 17 years old was associated with the occurrence of Crohn's disease (OR=1.63; 95% CI: 1.13-2.36), but not ulcerative colitis (OR=0.98; 95% CI: 0.60-1.60) in adulthood.
In this study, the occurrence of sexual violence, parental neglect, the death of a loved one or anxiety disorders during childhood and/or adolescence was associated with the development of IBD in adulthood. Our results bring new light to the etiological puzzle of IBD by focusing on psychosocial factors and their accumulation during periods of vulnerability. Further studies taking into account resilience and assessing microbiota changes will be needed to confirm these results.
- Posted in: Poster Presentations: Epidemiology 2023