This article is more than 5 years old. Information may no longer be current.
Anxiety predicts worse outcomes in IBD
Patients with anxiety had poorer inflammatory bowel disease-related outcomes, but researchers did not find the same predictive value for depression, according to research published in Inflammatory Bowel Diseases.
Neeraj Narula, MD, MPH, FRCP, of the department of medicine and Farncombe Family Digestive Health Research Institute at McMaster University in Hamilton, Canada, and colleagues wrote that patients with IBD have higher rates of psychiatric comorbidities. While depression is linked to decreased quality of life, they wanted to determine if anxiety or depression could result in poorer outcomes for patients.
“Patients with inflammatory bowel diseases (IBD) have higher rates of anxiety and depression compared with the general population,” Narula told Healio Gastroenterology and Liver Disease. “Predictive factors of patients at high risk of poor IBD-related outcomes would be helpful for clinicians to focus limited resources and target management strategies towards.”
In a prospective longitudinal follow-up study performed in Ontario, Canada between 2008 and 2016, researchers asked patients to complete questionnaires at the time of their initial assessment, including the Hospital Anxiety and Depression Scale (HADS). They tested clinical variables — such as IBD-related hospitalization and emergency room visits — and their ability to predict poor IBD-related outcomes.
Of 414 patients who completed the questionnaire, 125 had anxiety and/or depression at baseline. Severity of disease at presentation, prior IBD-related surgery, longer duration of follow-up, and elevated C-reactive protein were all factors that predicted poor IBD outcomes.
Investigators found that patients with abnormal anxiety subscores were more likely to experience poor IBD-related outcomes compared with patients without higher anxiety levels (OR = 3.36; 95% CI, 1.51–7.48). They found no difference in IBD outcomes among patients with abnormal depression scores (OR = 0.43; 95% CI, 0.14–1.32).
Narula said the odds increased as anxiety grew worse.
“Patients in the highest quartile of baseline anxiety score were significantly more likely to experience poor IBD-related outcomes,” he said. “Further studies are needed to determine whether focused treatment of anxiety in this group of patients can improve IBD-related outcomes as well.” – by Alex Young
Disclosures: Narula reports no relevant financial disclosures.
Editor's note: This article was updated on Jan. 9, 2019, to include Narula's relevant disclosures.