Psychiatric disorders linked to increased risk of complicated appendicitis
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There is a close relationship between psychiatric disorders, psychotropic prescription and treatment compliance, and the risk for complicated appendicitis, researchers reported in BMC Psychiatry.
“This study revealed a close relationship between the risks of complicated appendicitis and psychiatric disorders, including psychotic and bipolar disorders,” Junmo Kim, MS, PhD, of Seoul National University in Korea, and colleagues wrote. “Additionally, the critical factor eliciting complicated acute appendicitis in psychiatric patients was the disease itself, but not the duration of taken medication.”
For the retrospective observational cohort study, Kim and colleagues collected data from 47,500 participants with acute appendicitis to evaluate the impact of psychiatric disorder, psychotropic prescription and treatment compliance on the risk for acute appendicitis.
Data were collected from January 2000 to December 2020 from four different medical centers in Korea that were included in the Observational Medical Outcomes Partnership common data model.
Participants were divided into groups of complicated and uncomplicated appendicitis, with or without a psychiatric disorder diagnosis and with or without a psychotropic medication prescription. The OR for the study results was adjusted by sex and age.
Kim and colleagues found that the presence of both psychotic disorder (adjusted OR, 1.951; 95% CI, 1.218–3.125) and bipolar disorder (aOR, 2.323; 95% CI, 1.194–4.520) were associated with increased risks of complicated appendicitis compared with those without psychiatric disorders.
Participants taking high daily-dose antipsychotics for less than 1 year (aOR, 1.896; 95% CI, 1.077–3.338) and for 1 to 5 years (aOR, 1.93; 95% CI, 1.144–3.256) both had increased risks of complicated appendicitis. In addition, low treatment compliance was associated with increased risk of complicated appendicitis (aOR, 1.664; 95% CI, 1.014–2.732).
“This study can enhance the attention of medical professionals, thereby prompting them not to miss the signs of urgent physical comorbidity in patients with psychiatric disorders,” Kim and colleagues wrote. “Medical personnel should remain alert to the possibility that serious, potentially life-threatening physical conditions occur in patients with psychotic and bipolar disorders, who infrequently present with pain symptoms.”