Depression is prevalent in inflammatory bowel disease patients.
The impact of depression on inflammatory bowel disease is not well-studied.
It is unknown how providers should assess depression.
Dr Robert Sandler and colleagues from North Carolina, USA used data from the Sinai–Helmsley Alliance for Research Excellence cohort, to assess methods of diagnosing depression and effects of baseline depression on disease activity at follow-up.
A patient health questionnaire score ≥5 was consistent with mild depression.
Relapse was defined as a modified Harvey–Bradshaw Index ≥5 or Simple Clinical Colitis Activity Index >2.
The team performed binomial regression to calculate adjusted risk ratios.
The researcheres included 2,798 Crohn’s disease patients with 22-month mean follow-up and 1,516 ulcerative colitis patients with 24-month mean follow-up.
A total of 64% of Crohn’s disease patients and 45% of ulcerative colitis patients were in remission at baseline.
|By patient health questionnaire-8, 38% of Crohn’s disease patients were depressed|
|Inflammatory Bowel Diseases|
By self-report, 20% of Crohn’s disease and 14% of ulcerative colitis patients were depressed.
By patient health questionnaire-8, the team found that 38% of Crohn’s disease and 32% of ulcerative colitis patients were depressed.
Adjusted for sex, remission, and disease activity, Crohn’s disease patients with baseline depression were at an increased risk for relapse, surgery, or hospitalization at follow-up.
Ulcerative colitis patients with baseline depression were also at increased risk for relapse, surgery, or hospitalization at follow-up.
Dr Sandler's team concluded, "Baseline depression is associated with a higher risk for aggressive inflammatory bowel disease at follow-up."
"A single question is not a sensitive method of assessing depression."
"Providers should consider administering the patient health questionnaire-8 to capture those at greater risk for aggressive disease."