Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 10;25(2):360-368.
doi: 10.1093/ibd/izy235.

Increased Burden of Psychiatric Disorders in Inflammatory Bowel Disease

Charles N Bernstein  1 , Carol A Hitchon  1 , Randy Walld  2 , James M Bolton  3 , Jitender Sareen  3 , John R Walker  4 , Lesley A Graff  4 , Scott B Patten  5 , Alexander Singer  6 , Lisa M Lix  2   7 , Renée El-Gabalawy  8   5 , Alan Katz  2   6   7 , John D Fisk  8   9   10   11 , Ruth Ann Marrie  1   6 ; CIHR Team in Defining the Burden and Managing the Effects of Psychiatric Comorbidity in Chronic Immunoinflammatory Disease
Affiliations

Increased Burden of Psychiatric Disorders in Inflammatory Bowel Disease

Charles N Bernstein et al. Inflamm Bowel Dis. .

Abstract

Background: Psychiatric comorbidity in inflammatory bowel disease (IBD) is well known; however, data from a truly representative sample are sparse. We aimed to estimate the incidence and prevalence of psychiatric disorders in an IBD cohort compared with a matched cohort without IBD.

Methods: Using population-based administrative health data from Manitoba, Canada, we identified all persons with incident IBD from 1989 to 2012 and a general population matched cohort (5:1). We applied validated algorithms for IBD, depression, anxiety disorders, bipolar disorder, and schizophrenia to determine the annual incidence of these conditions post-IBD diagnosis and their lifetime and current prevalence.

Results: There were 6119 incident cases of IBD and 30,573 matched individuals. After adjustment for age, sex, socioeconomic status, region of residence, and year, there was a higher incidence in the IBD cohort compared with controls for depression (incidence rate ratio [IRR], 1.58; 95% confidence interval [CI], 1.41-1.76), anxiety disorder (IRR, 1.39; 95% CI, 1.26-1.53), bipolar disorder (IRR, 1.82; 95% CI, 1.44-2.30), and schizophrenia (IRR, 1.64; 95% CI, 0.95-2.84). Incidence rate ratios were similar for Crohn's disease and ulcerative colitis between males and females and were stable over time. However, within the IBD cohort, the incidence rates of depression, anxiety, and bipolar disorders were higher among females, those aged 18-24 years vs those older than 44 years, urbanites, and those of lower socioeconomic status. The lifetime and current prevalence rates of psychiatric disorders were also higher in the IBD than the matched cohort.

Conclusions: The incidence and prevalence of psychiatric disorders are elevated in the IBD population.

PubMed Disclaimer

Figures

FIGURE 1.
FIGURE 1.
Average annual age-specific incidence of psychiatric disorders. Error bars represent 95% confidence intervals. A, Depression. B, Anxiety disorder. C, Bipolar disorder. D, Schizophrenia.
FIGURE 2.
FIGURE 2.
Age-specific lifetime and current prevalence of psychiatric disorders in 2011. Error bars represent 95% confidence intervals. A, Depression. B, Anxiety disorder. C, Bipolar disorder. D, Schizophrenia.
See this image and copyright information in PMC

References

    1. Regueiro M, Greer JB, Szigethy E. Etiology and treatment of pain and psychosocial issues in patients with inflammatory bowel diseases. Gastroenterology. 2017;152:430–439.e4. - PubMed
    1. Mittermaier C, Dejaco C, Waldhoer T, et al. . Impact of depressive mood on relapse in patients with inflammatory bowel disease: a prospective 18-month follow-up study. Psychosom Med. 2004;66:79–84. - PubMed
    1. Persoons P, Vermeire S, Demyttenaere K, et al. . The impact of major depressive disorder on the short- and long-term outcome of Crohn’s disease treatment with infliximab. Aliment Pharmacol Ther. 2005;22:101–110. - PubMed
    1. Mikocka-Walus A, Pittet V, Rossel JB, et al. ; Swiss IBD Cohort Study Group Symptoms of depression and anxiety are independently associated with clinical recurrence of inflammatory bowel disease. Clin Gastroenterol Hepatol. 2016;14:829–835.e1. - PubMed
    1. Graff LA, Walker JR, Bernstein CN. Depression and anxiety in inflammatory bowel disease: a review of comorbidity and management. Inflamm Bowel Dis. 2009;15:1105–1118. - PubMed

Publication types