Depression Is Associated With More Aggressive Inflammatory Bowel Disease.

Area of Science:

• Gastroenterology
• Psychiatry
• Clinical Research

Background:

• Depression is common in patients with inflammatory bowel disease (IBD).
• The impact of depression on IBD disease activity and progression is not well understood.
• Current methods for assessing depression in IBD patients are inadequate.

Purpose of the Study:

• To evaluate the association between baseline depression and IBD disease activity at follow-up.
• To assess the effectiveness of the Patient Health Questionnaire-8 (PHQ-8) in identifying depression among IBD patients.
• To provide guidance for healthcare providers on depression assessment in IBD.

Main Methods:

• Utilized data from the Sinai-Helmsley Alliance for Research Excellence cohort.
• Assessed depression using the PHQ-8, with a score ≥5 indicating mild depression.
• Analyzed associations between baseline depression and IBD relapse, surgery, or hospitalization using binomial regression.

Main Results:

• Higher prevalence of depression detected by PHQ-8 (38% in Crohn's disease, 32% in ulcerative colitis) compared to self-report.
• Patients with Crohn's disease and baseline depression had increased risk of relapse (RR: 2.3) and hospitalization/surgery (RR: 1.3).
• Patients with ulcerative colitis and baseline depression had increased risk of hospitalization/surgery (RR: 1.3).

Conclusions:

• Baseline depression is a significant risk factor for more aggressive IBD outcomes.
• A single-question depression screening is insufficient for IBD patients.
• Routine administration of the PHQ-8 is recommended for identifying at-risk IBD patients.