UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

UEG Week Berlin 2025 Recordings Gut Guide online

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Poster

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

PSYCHIATRIC AND SOCIOECONOMIC ASPECTS OF FAMILIAL ADENOMATOUS POLYPOSIS – A NATIONWIDE DANISH COHORT STUDY WITH MATCHED CONTROLS

John Gásdal Karstensen 1, Laus Wullum 2, Klaus Kaae Andersen 2, Søren Hammershøj Beck 3, Steffen Bülow 3, Helle Højen 3, Anne Marie Jelsig 4, Niels Jespersen 3, Mads Damsgaard Wewer 5, Hans Christian Pommergaard 6, Johan Burisch 5

Affiliations

1 Copenhagen University Hospital Hvidovre, Hvidovre, Denmark|||Department of Clinical Medicine, Copenhagen, Denmark

2 Omicron ApS, Copenhagen, Denmark

3 Copenhagen University Hospital Hvidovre, Hvidovre, Denmark

4 Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark

5 Copenhagen University Hospital Hvidovre, Hvidovre, Denmark|||Copenhagen University Hospital Hvidovre, Hvidovre, Denmark

6 Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark|||Department of Clinical Medicine, Copenhagen, Denmark

Summary

AI Generated

A Danish nationwide registry study found that patients with familial adenomatous polyposis have significantly lower educational attainment and increased risk of psychiatric disorders compared to matched controls.

The study included 445 FAP patients and 1,538 matched controls from the Danish Polyposis Register, comparing educational status and psychiatric outcomes using national registries.
FAP patients had significantly lower educational attainment (p<0.001) and increased risk of any psychiatric event (HR 1.55, 95% CI 1.32–1.83, p<0.001) compared to controls when adjusting for cancer diagnosis.
Specific increased risks were observed for affective disorders (HR 1.76, 95% CI 1.09–2.83), behavioral disorders (HR 2.01, 95% CI 1.10–3.69), and prescriptions for antidepressants (HR 1.59) and antipsychotics (HR 1.85).
Median ages for affective and behavioral disorders in FAP patients were 32.7 years and 14.7 years respectively, which did not differ from controls.
The authors conclude that these findings call for further exploratory and interventional trials addressing mental health in FAP patients.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Familial adenomatous polyposis (FAP) is a dominantly inherited disorder that predisposes to colorectal cancer. However, after the introduction of prophylactic colectomy and endoscopic surveillance, as well as genetic screening of first-degree family members, the risk of CRC has decreased dramatically with subsequent prolonged expected life expectancy^.1 Current guidelines solely aim at preventing cancer, which has been the focus for decades.^2-3 From a patient perspective, mental aspects of the disease, which might decrease quality of life may be equally important. However, knowledge and focus on mental well-being in FAP patients is limited. If FAP patients are at increased risk of mental stress and ultimately of developing psychiatric disorders, a potential possibility of early intervention is missed. The Danish Polyposis Register has for over 40 years included data from all Danish FAP patients. Consequently, the register is free of referral and selection bias. We aimed this study at estimating the impact on educational level and risk of psychiatric disorders in a nationwide cohort of patients with FAP compared to a matched background population.

Aims & Methods

Known Danish FAP patients by April 2021 were identified from the Danish Polyposis Register and paired with four matched controls based on matched on sex, birth year, and zip code at birth. Using national registries, educational status, psychiatric contacts or diagnoses, and need for antidepressants, anxiolytics, or antipsychotics were compared between FAP patients and controls. Follow-up of patients started on the date of their first being identified as having FAP or on 1^st January 1996, whichever came last. Follow-up ended on the date of any of the listed outcomes, emigration, death, loss to follow-up or the end of the study on 1^st January 2020, whichever came first. Relative risk for any of the listed outcomes was quantified by hazard ratios (HR); these were estimated using Cox proportional hazards regression, with age as the underlying timescale, and used the variables of exposure status, year of outcome, sex, cancer, and education for the multiple regression model. Cancer was included as a time-varying covariate in the Cox proportional hazards regressions.

Results

The analysis included 445 FAP patients and 1,538 controls. The highest attained education was significantly lower for FAP patients (p<0.001). When comparing FAP patients and controls and adjusting for cancer diagnosis, an increased risk was observed for a psychiatric contact (1.69, CI 95%, 1.25–2.29, p<0.001), any psychiatric prescription (1.39, CI 95%, 1.17–1.66, p<0.001), receiving a psychiatric diagnosis (1.64, CI 95%, 1.19–2.26, p=0.002), as well as facing any psychiatric event (HR 1.55, CI 95%, 1.32–1.83, p<0.001). An increased risk was specifically seen for affective (1.76, CI 95%, 1.09–2.83, p=002) and behavioral disorders (2.01, CI 95%, 1.10–3.69, p=0.02) as well as prescription of antidepressants (1.59, CI 95%, 1.24–2.03, p<0.001) and antipsychotics (1.85, CI 95%, 1.26–2.70, p=0.002). For FAP patients, the median age for affective and behavioral disorders was 32.7 years (range 15.0–73.6 years) and 14.7 years (range 5.5–47.7 years), respectively, which did not differ from controls.

Conclusion

Compared to controls, FAP patients have a significantly reduced educational level and an increased risk of developing affective and behavioural disorders with increased needs for antidepressants and antipsychotics. This calls for further exploratory and interventional trials.

References

1 Karstensen JG, Burisch J, Pommergaard HC, et al. Colorectal Cancer in Individuals With Familial Adenomatous Polyposis, Based on Analysis of the Danish Polyposis Registry. Clin Gastroenterol Hepatol 2019; 17(11): 2294-300 e1.
2 Monahan KJ, Bradshaw N, Dolwani S, et al. Guidelines for the management of hereditary colorectal cancer from the British Society of Gastroenterology (BSG)/Association of Coloproctology of Great Britain and Ireland (ACPGBI)/United Kingdom Cancer Genetics Group (UKCGG). Gut 2020;69(3):411-44.
3 van Leerdam ME, Roos VH, van Hooft JE, et al. Endoscopic management of polyposis syndromes: European society of gastrointestinal endoscopy
(ESGE) guideline. Endoscopy 2019;51:877–95.

Disclosure

JGK is consultant for SNIPR BIOME

Conference

UEG Week Copenhagen 2023

Topics

Colorectal

Submission format

Abstract

Session

PP 06 Other lower GI disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

More Like This:

ENDOSCOPIC SURVEILLANCE IN PATIENTS WITH PATHOGENIC VARIANTS IN CDH1 OR CTNNA1 – A REAL WORLD SCENARIO

Robert Hüneburg

ENDOSCOPIC SCORING INDICES FOR ASSESSING DISEASE SEVERITY IN FAMILIAL ADENOMATOUS POLYPOSIS: A SYSTEMATIC REVIEW

Brian G. Feagan

THE USEFULNESS OF ENDOSCOPIC HAND-SUTURING (EHS) FOR CLOSURE OF THE MUCOSAL DEFECT AFTER GASTRIC ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD)

Michiko Nakaoka

SMALL-BOWEL CANCER SURVEILLANCE WITH CAPSULE ENDOSCOPY IN LYNCH SYNDROME – A SYSTEMATIC REVIEW WITH META-ANALYSIS

Luigi Andrea Laghi

HIGH-RISK POLYPS AND COLORECTAL CANCER IN PATIENTS WITH HEREDITARY DIFFUSE GASTRIC CANCER

Mario Dinis-Ribeiro

Quiet quitting in nursing and healthcare professions

Gerlinde Weilguny-Schoefl

UEG Poster

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

ENDOSCOPIC SURVEILLANCE IN PATIENTS WITH PATHOGENIC VARIANTS IN CDH1 OR CTNNA1 – A REAL WORLD SCENARIO

Anna Bettzüge 1, Tim Marwitz 1, Stefan Aretz 2, Isabel Spier 2, Tim Ripperger 3, Silke Redler 4, Alexander E. Volk 5, Andreas Block 6, Deepak Vangala 7, Severin Daum 8, Elke Holinski-Feder 9, Verena Steinke-Lange 9, Katrin Bahlke 10, Christian Strassburg 1, Jacob Nattermann 1, Robert Hüneburg 1

Affiliations

1 University Hospital Bonn, Bonn, Germany

2 University Bonn, Medical Faculty, Bonn, Germany

3 Hannover Medical School, Hannover, Germany

4 University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany

5 University Hospital Hamburg-Eppendorf, Hamburg, Germany

6 University Medical Center Hamburg-Eppendorf, Hamburg, Germany

7 Knappschaftskrankenhaus Bochum, Ruhr-Universität Bochum, Bochum, Germany

8 Charité University Medicine Berlin, Campus Benjamin Franklin (CBF), Berlin, Germany

9 MGZ - Medizinisch Genetisches Zentrum, München, Germany|||Klinikum der Universität München, München, Germany

10 University Hospital Münster, Münster, Germany