Prevalence and Predictors of Symptoms of Anxiety or Depression at Diagnosis in Patients With Inflammatory Bowel Disease: An Inception Cohort

Abstract

BackgroundThe prevalence of symptoms of a common mental disorder, including anxiety or depression, is high among patients with established inflammatory bowel disease (IBD). This may represent a therapeutic target for affected patients. However, whether these symptoms arise from genuine gut‐brain effects, or are merely a consequence of a preceding adverse disease course is unclear.AimsTo assess prevalence and predictors of anxiety and depression in an inception cohort of patients with IBD.MethodsWe collected demographic data, disease‐related information, diagnosis of a pre‐existing common mental disorder, symptoms of a common mental disorder, using the hospital anxiety and depression score, and gastrointestinal symptom‐specific anxiety, using the Visceral Sensitivity Index (VSI), from individuals newly diagnosed with IBD during their index outpatient appointment or inpatient admission. The prevalence of symptoms of a common mental disorder at diagnosis, and predictors of the presence of these symptoms, were examined.ResultsOf 300 participants, 117 (39.0%) reported symptoms of a common mental disorder (107 (35.7%) anxiety, 47 (15.7%) depression). Younger age, female sex, tobacco use, a longer duration of symptoms prior to diagnosis, higher gastrointestinal symptom‐specific anxiety, and stressful life events in the preceding 12 months were associated with a significantly increased likelihood of reporting these symptoms. Higher gastrointestinal symptom‐specific anxiety remained significant following logistic regression (OR 2.19; 95% CI 1.00–4.79 for VSI moderate and OR 13.5; 95% CI 5.86–31.2 for VSI high, p < 0.001 for trend).ConclusionPoor psychological health is highly prevalent at the time of an IBD diagnosis, suggesting genuine gut‐brain effects.