Early Improvement of Mental Health is Associated with Long-term Disease Remission in Ulcerative Colitis.

Background and aims: Emerging evidence highlight the critical role of mental health in the management of ulcerative colitis (UC). We investigated the relationship between early mental health improvement and long-term disease remission.

Methods: This study utilized data from the SELECTION trial involving 381 patients treated with filgotinib. Mental health was assessed using the mental health subscale of the 36-item Short-Form Survey. Endoscopic, clinical, and histologic outcomes were assessed at week 58. Adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) were calculated using multivariate logistic regression. Receiver operating characteristic curves, combined with bootstrap resampling, were used to define the mental health response threshold.

Results: Early mental health improvements at week 10 were significantly associated with disease remission at week 58. Patients who showed a mental health response (subscale score changes of ≥7.85) exhibited greater odds of achieving endoscopic remission (aOR 2.67, 95% CI: 1.43-5.25), clinical remission (aOR 1.91, 95% CI: 1.22-2.99), histologic remission (aOR 1.98, 95% CI: 1.27-3.12), and disease clearance (aOR 3.48, 95% CI: 1.74-7.50). Additionally, incorporating mental health response assessment along with clinical remission significantly enhanced outcome predictions. Specifically, individuals with only clinical remission at week 10 were approximately half as likely to reach week-58 endoscopic remission (aOR 0.45, 95% CI: 0.21-0.91) compared to those who attained both mental health response and clinical remission.

Conclusion: Early mental health improvements independently predicted long-term disease remission. Integrating mental health assessments into UC management strategies may provide valuable insights beyond physical symptoms.