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Rates of depression, anxiety after surgery similar for patients with Crohn’s disease, ulcerative colitis
Depression and anxiety occurred at similar rates in patients with Crohn’s disease and ulcerative colitis following bowel resection surgery in a recent study.
Researchers evaluated 707 patients with Crohn’s disease (CD) and 530 with ulcerative colitis (UC) who underwent bowel resection. No participants had exhibited depression symptoms before the study.
Depression was diagnosed in 128 patients with CD (median time to diagnosis 2.2 years), and 54 with UC (median 2.5 years). The condition occurred in 16% of patients with CD and 11% of those with UC at 5 years after resection.
Multivariate analysis indicated no significant difference in risk between those with CD and UC (adjusted OR=1.11, 0.84-1.47). Patients who required surgery were at significantly increased risk compared with those who did not among CD patients (aOR=1.34, 1.01-1.77), but not those with UC (OR=1.21, 0.93-1.58) (95% CI for all).
Investigators also noted that CD patients hospitalized at least once for IBD were nearly twice as likely to experience depression (OR=1.91, 1.60-2.77) as those who had not, while those with UC were at increased risk for depression (OR=1.28, 1.06-1.54) and anxiety (OR=1.32, 1.09-1.59) when hospitalized.
Anxiety occurred at a rate of 14% among CD patients and 12% in UC patients at 5 years after surgery. A slight risk was observed for surgery recipients for CD (OR=1.20, 0.93-1.55) and UC (OR=1.26, 0.96-1.65) (95% CI for all).
Factors associated with postsurgical depression among patients with CD included comorbidities (OR=4.31, 2.82-6.57), undergoing stoma surgery (OR=1.90, 1.15-3.13), female sex (OR=1.77, 1.16-2.7), the use of immunosuppressants (OR=1.56, 1.03-2.38), perianal disease (OR=1.64, 1.01-2.69), and surgery performed within 3 years of initial care (OR=1.54, 1.01-2.37). Among patients with UC, only female sex (OR=2.92, 1.80-4.76) and other comorbidities (OR=3.73, 2.33-5.97) were predictive of depression (95% CI for all).
Ashwin N. Ananthakrishnan
“Our main goal … is to provide comprehensive IBD care,” researcher Ashwin N. Ananthakrishnan, MD, MPH, Massachusetts General Hospital Crohn’s and Colitis Center, told Healio.com. “This means not just focusing on the medical or surgical treatment of these diseases, but also understanding the impact of these diseases on patients’ lives. Psychological comorbidity is an important ‘extraintestinal’ manifestation of CD and UC, and treating physicians need to continue to remain aware of its occurrence so it can be treated appropriately.”