Eosinophilic esophagitis patients at greater risk of later psychiatric disorder

The risk of psychiatric disease is higher in individuals with eosinophilic esophagitis (EoE) compared to their siblings and the general population, reveals a study. This risk must be addressed in clinical care to detect, prevent, and treat comorbidity.

In this population-based nationwide cohort study, the investigators identified a total of 1,458 individuals with EoE (median age 39 years, 76 percent male) diagnosed during 1989‒2017 in Sweden through the ESPRESSO histopathology cohort, representing all gastrointestinal biopsy reports in the country’s 28 pathology departments.

EoE patients were matched with up to five reference individuals based on sex, age, county, and calendar year (n=6,436). Cox proportional hazard modeling was used to estimate the adjusted hazard ratios (HRs). Finally, the investigators compared individuals with EoE to their siblings to adjust for intrafamilial confounding in a secondary analysis.

One hundred six EoE patients (15.96 per 1,000 person-years) developed a psychiatric disorder during a median follow-up of 4 years compared with 331 reference individuals (10.93 per 1,000 person-years), which corresponded to an HR of 1.50 (95 percent confidence interval [CI], 1.20‒1.87).

The risk increase occurred in the first 5 years of follow-up but not afterwards. The highest relative risks were noted in individuals diagnosed with EoE in childhood. EoE patients were also at greater risk of psychiatric disease than their siblings (HR, 1.62, 95 percent CI, 1.14‒2.31). In addition, EoE was associated with mood disorders, anxiety disorder, and attention-deficit hyperactivity disorder.