Patients with ulcerative colitis and Crohn’s disease demonstrate increased risk for psychiatric illnesses
Individuals with ulcerative colitis (UC) or Crohn disease (CD) are more likely to have depression, anxiety, and bipolar disorder.
Patients with inflammatory bowel disease, including UC and CD, have been shown to be at increased risk for psychiatric illnesses, although most previous studies have had limited patient populations. The researchers retrospectively reviewed a large commercial database of information collected between 2013 and 2019 to better define the epidemiology of several psychiatric illnesses (depression, anxiety, bipolar disorder) in patients with UC and CD.1,2
In patients with UC, the prevalence of depression, anxiety, and bipolar disorder was 17%, 23%, and 4%, respectively. Each of these disorders was more common in those with UC than in those without UC.1 Similarly, those with CD had a higher prevalence of depression (19%), anxiety (25%), and bipolar disorder (8%) compared with those without CD.2
For both patients with UC and CD, psychiatric diagnoses were more common in patients who were elderly (greater than 65 years old), who were women, and who were white.1,2 In addition, patients with UC or CD with these psychiatric conditions more frequently had a history of alcohol abuse, tobacco and substance abuse, personality disorder, and corticosteroid use.1,2
This large retrospective study emphasizes the importance of screening all patients with UC and CD for psychiatric illnesses. It is possible that the prevalence of these conditions found in this study actually underestimates the real-world risks, especially if healthcare practitioners are not screening patients adequately. Many societies, including the Crohn and Colitis Foundation, have made formal recommendations to screen patients with UC and CD routinely for mental health conditions. At minimum, this should be done annually, but ideally it should be done at every visit. Many patients with inflammatory bowel disease have medically complex conditions and this part of the visit can be easily overlooked. Future studies evaluating the impact of psychiatric illnesses on endoscopic and clinical remission, medication regimen, and overall clinical outcomes could help further characterize the importance of addressing these conditions.
1. Chouhan V, Mansoor E, Saleh MA, Katz J, Regueiro M, Cooper GS. Epidemiology of major depressive disorder, anxiety disorder, and bipolar disorder in ulcerative colitis in the United States between 2014 and 2019: a population-based national study. Presented at: American College of Gastroenterology 2019 Annual Scientific Meeting; October 25-30, 2019; San Antonio, TX. Abstract P0466.
2. Chouhan V, Mansoor E, Saleh MA, Katz J, Regueiro M, Cooper GS. Epidemiology of major depressive disorder, anxiety disorder, and bipolar disorder in Crohn’s disease in the United States between 2014 and 2019: a population-based national study. Presented at: American College of Gastroenterology 2019 Annual Scientific Meeting; October 25-30, 2019; San Antonio, TX. Abstract P0467.