Acute pancreatitis hospitalisations higher in people with severe mental illness

  • Vithayathil M & al.
  • J Affect Disord
  • 11 Nov 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Severe mental illness (SMI) was associated with a significantly increased risk for acute pancreatitis.
  • Co-morbid alcohol use disorder (AUD) was an independent risk factor for the development of pancreatitis in patients with SMI.

Why this matters

  • This is the first study to investigate acute pancreatitis hospitalisations in people with severe mental illness.

Study design

  • Study of 2 phases:
    • In phase 1, retrospective cohort study included 22,337 patients with SMI.
    • In phase 2, nested-case control study included 80 patients with SMI with acute pancreatitis admission (cases) and 308 without acute pancreatitis admission (control).
  • Funding: The National Institute for Health Research Biomedical Research Centre and others.

Key results

  • SMI was associated with an increased risk of admission for acute pancreatitis (standardised admission ratio [SAR], 2.33; 95% CI, 1.97-2.74).
  • For all admission events, population attributable fraction (PAF) for AUD was 33.97% in patients with SMI.
  • The PAF for patients with schizophrenia and bipolar affective disorder were similar (36.98% and 36.90%) but lower for schizoaffective disorder (21.80%).
  • The PAF was higher in men with SMI vs women (38.14% vs 25.84%).
  • In the nested case-control study, co-morbid AUD was an independent risk factor for acute pancreatitis (adjusted OR, 16.10; 95% CI, 5.92-43.79).

Limitation

  • Diagnosis of co-morbid AUD may be underrepresented in patients with SMI.