Patients with IBD, ‘higher social vulnerability’ inadequately screened for mental health
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DENVER — Depression was associated with higher social vulnerability in individuals with inflammatory bowel disease and was largely influenced by socioeconomic and minority status, according to data at the Crohn’s and Colitis Congress.
“Similar to their chronic disease counterparts, patients with IBD have higher rates of anxiety and depression than the general population,” Ariel A. Jordan, MD, an internist at the University of Michigan, told Healio. “We are increasingly recognizing IBD as a chronic disease affecting patients of diverse backgrounds, including those significantly impacted by social determinants of health.”
In a retrospective study, Jordan and colleagues evaluated the association between social determinants of health, measured by the CDC’s social vulnerability index (SVI), and comorbid depression or anxiety among 14,920 patients with IBD.
Researchers reported lower rates of screening for both depression (17% vs. 9.9%) and anxiety (9.2% vs. 5.8%) in patients with high social vulnerability compared with low social vulnerability. Among 8,089 patients included in the regression model, 21% had anxiety and 20% had depression, with a reported mean SVI of 0.36.
Study results also showed a higher overall SVI among patients with depression (adjusted OR = 1.37; 95% CI, 1.09-1.71) compared with anxiety (aOR = 0.89; 95% CI, 0.71-1.11), with socioeconomic status (aOR = 1.78; 95% CI, 1.29-2.47) and minority/language subdomains (aOR = 1.26; 95% CI, 1.02-1.55) among the riskiest social determinants.
Although anxiety was not associated with increased social vulnerability, it was higher among individuals with elevated scores in the minority/language subdomain (aOR = 1.45; 95% CI, 1.19-1.77).
“Our big takeaway is that it appears that patients with higher social vulnerability are not being screened [for mental health] in the same way patients with lower social vulnerability are, which is unfortunate because all IBD patients should be getting yearly mental health screening,” Jordan said. “I think this data is the first step toward awareness for providers and eliminating barriers and biases around mental health screening.”
She added, “Ultimately, we hope this work will bring to the forefront the unique challenges patients with high social vulnerability face in addition to their IBD, so we as providers can work to ensure all patients are receiving equitable health care.”
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Jordan AA, et al. Poster 012: Do providers fail to recognize anxiety in socially vulnerable patients with inflammatory bowel disease?; Presented at: Crohn’s and Colitis Congress; Jan. 19-21, 2023; Denver.
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