Influences and impact of Anxiety and Depression in the setting of inflammatory bowel disease

Seyedehsan Navabi, Venkata Subhash Gorrepati, Jaykrishna Chintanaboina, Sarah Maher, Peter Demuth, Benjamin Stern, August Stuart, Andrew Tinsley, Kofi Clarke, Emmanuelle Williams, Matthew Coates, Sanjay Yadav

Research output: Contribution to journalArticlepeer-review

98 Scopus citations


Background: Individuals with inflammatory bowel disease (IBD) are at increased risk of developing anxiety or depression (A & D). Crohn's disease (CD) and ulcerative colitis (UC) with comorbid A & D are both more challenging to manage. IBD providers need to better understand the causes and impact of A & D in order to improve care for IBD patients. We sought to identify clinical factors that influence development of A & D and healthcare utilization in IBD. Methods: This is a retrospective analysis using an IBD natural history registry from a single tertiary care referral center. Presence of A & D was determined based upon responses to the Hospital Anxiety and Depression Scale. Demographic and clinical factors were abstracted to evaluate for significant associations. Results: Four hundred thirty-two IBD patients (132 UC, 256 CD, and 44 indeterminate colitis) were included in this study. One hundred ninety-two (44.4%) had anxiety or depression or both, and most were female (59.4%, P < 0.05). History of surgery (P < 0.05), female gender (P < 0.05), smoking (P < 0.05), and extra-intestinal manifestations (P < 0.01) were each independently predictive of A & D. Inflammatory bowel disease patients with A & D more often underwent imaging studies (53.6% vs 36.7%, P < 0.05), visited the ED (30.7% vs 20.8%, P < 0.05), or were hospitalized (31.7% vs 21.7%, P < 0.05). They were also more frequently prescribed corticosteroids (50.5% vs 36.7%, P < 0.01) and biologic medications (62.5% vs 51.3%, P < 0.05). Finally, they were more likely to have had at least 1 "no-show" (29.2% vs 16.7%, P < 0.01) and had a higher mean number of "no-shows" (0.69 +/- 0.1 vs 0.30 +/- 0.1, P < 0.01) over the study period. Discussion: Anxiety and depression are common in the setting of IBD and are strongly associated with surgical history, disease complications (including extra-intestinal manifestations), smoking, and female gender. Inflammatory bowel disease patients with A & D are also more likely to require therapy and to utilize healthcare resources. This study refines our understanding of A & D development and its impact in IBD and provides additional considerations for management in this setting.

Original languageEnglish (US)
Pages (from-to)2303-2308
Number of pages6
JournalInflammatory bowel diseases
Issue number11
StatePublished - Nov 1 2018

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Gastroenterology


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