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Psychiatric co-morbidity is associated with increased risk of surgery in Crohn's disease

Psychiatric co-morbidity is associated with increased risk of surgery in Crohn's disease

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Psychiatric co-morbidity, in particular major depression and anxiety, is common in patients with Crohn's disease and ulcerative colitis.

Prior studies examining this may be confounded by the co-existence of functional bowel symptoms.

Limited data exist examining an association between depression or anxiety and disease-specific endpoints such as bowel surgery.

Dr Ananthakrishnan and colleagues examined the frequency of depression and anxiety in a large multi-institution electronic medical record (EMR)-based cohort of Crohn's disease and ulcerative colitis patients.

The team defined the independent effect of psychiatric co-morbidity on risk of subsequent surgery or hospitalization in Crohn's disease and ulcerative colitis , and identified the effects of depression and anxiety on healthcare utilization,

Using a multi-institution cohort of patients with Crohn's disease and ulcerative colitis, the team identified those who also had co-existing psychiatric co-morbidity.

20% had either major depressive disorder or generalized anxiety
Alimentary Pharmacology & Therapeutics

The team of doctors included a total of 5405 Crohn's disease, and 5429 ulcerative colitis patients.

The researchers found that 20% had either major depressive disorder or generalized anxiety.

After the team adjusted for potential confounders and the propensity score, presence of mood or anxiety co-morbidity was associated with a 28% increase in risk of surgery in Crohn's disease.

The researchers found that the psychiatric co-morbidity was associated with increased healthcare utilization.

Dr Ananthakrishnan's team concluded, "Depressive disorder or generalized anxiety is associated with a modestly increased risk of surgery in patients with Crohn's disease."

"Interventions addressing this may improve patient outcomes."

Aliment Pharmacol Ther 2013: DOI: 10.1111/apt.12195
25 January 2013

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