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. 2019 May 10;8(5):654.
doi: 10.3390/jcm8050654.

Risk of Anxiety and Depression in Patients with Inflammatory Bowel Disease: A Nationwide, Population-Based Study

Kookhwan Choi  1 , Jaeyoung Chun  2   3 , Kyungdo Han  4 , Seona Park  5 , Hosim Soh  6 , Jihye Kim  7 , Jooyoung Lee  8 , Hyun Jung Lee  9 , Jong Pil Im  10 , Joo Sung Kim  11   12
Affiliations

Risk of Anxiety and Depression in Patients with Inflammatory Bowel Disease: A Nationwide, Population-Based Study

Kookhwan Choi et al. J Clin Med. .

Abstract

Background and aims: Inflammatory bowel disease (IBD) may be associated with anxiety and depression. The aim of this study was to evaluate the incidence of anxiety and depression in patients with IBD compared to the general population. Methods: A nationwide population-based cohort study was conducted using claims data from the National Healthcare Insurance service in Korea. We compared the incidence of anxiety and depression between 15,569 IBD patients and 46,707 non-IBD controls, age and sex matched at a ratio of 1:3.

Results: During a mean follow-up of six years, IBD patients experienced significantly more anxiety (12.2% vs. 8.7%; p < 0.001) and depression (8.0% vs. 4.7%; p < 0.001) compared to controls. The curves showing cumulative incidences of anxiety and depression showed a steep rise within one year following a diagnosis of IBD, leading to lines with a constant slope. The hazard ratio (HR) for new onset anxiety following a diagnosis of Crohn's disease (CD) and ulcerative colitis (UC) was 1.63 and 1.60, respectively, compared to controls (p < 0.001). Compared to controls, the HR for developing depression after a diagnosis of CD and UC was 2.09 and 2.00, respectively (p < 0.001). The risks of anxiety and depression in patients with IBD were higher compared to controls, except in those with diabetes mellitus, hypertension, and dyslipidemia, or who required immunomodulators and biologics within one year of the IBD diagnosis.

Conclusions: The risk of anxiety and depression increased after a diagnosis of IBD compared to the general population.

Keywords: anxiety; claims data; depression; inflammatory bowel disease.

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Conflict of interest statement

All authors disclose no financial, professional, or personal conflicts that are relevant to this publication.

Figures

Figure 1
Figure 1
Cumulative incidence of anxiety and depression. Kaplan-Meier curves showed the incidence of anxiety (A–C) in patients with inflammatory bowel disease (A), Crohn’s disease (B), and ulcerative colitis (C), and depression (D-F) in those with inflammatory bowel disease (D), Crohn’s disease (E), and ulcerative colitis (F), compared to the general population, respectively. CD, Crohn’s disease; IBD, inflammatory bowel disease; UC, ulcerative colitis.
Figure 2
Figure 2
Subgroup analysis for the risk of anxiety in patients with (A) Crohn’s disease; and (B) ulcerative colitis compared to control groups. CD, Crohn’s disease; CI, confidence interval; UC, ulcerative colitis.
Figure 3
Figure 3
Subgroup analysis for the risk of depression in patients with (A) Crohn’s disease; and (B) ulcerative colitis compared to control groups. CD, Crohn’s disease; CI, confidence interval; UC, ulcerative colitis.
See this image and copyright information in PMC

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