Self-reported depressive symptoms and suicidal feelings in perianal Crohn's disease

Crohn's disease is a chronic inflammatory condition that has been associated with high rates of mental illness. Perianal lesions are prevalent; however, their specific impact on depression has not been studied. The aim of our study was to investigate the prevalence and associations of self-reported depressive symptoms in the subset of Crohn's patients with perianal disease.

Patients with perianal Crohn's disease from one institution were surveyed to elicit the frequency of self-reported depressive symptoms. Patients completed a questionnaire and consented to medical records audit.

Of the 130 patients invited, 69 (53%) returned a survey. Depressive symptoms were self-reported at very high rates, with 73% reporting feeling depressed and 13% reporting feeling suicidal at some point. Associations were found between depressive symptoms and duration of disease, prior surgery, past or present stoma, and anal stenosis. Patients who self-reported depressive symptoms had lower overall utilities, and were willing to trade very significant proportions (upwards of 15%) of their life expectancy for disease cure.

This study suggests that many patients with perianal Crohn's disease experience significant emotional distress that impairs their overall quality of life. Further controlled studies are required to assess the impact of perianal disease and to address the need to target interventions to meet the mental health needs of this population.