Inflammatory bowel disease (IBD) activity and depression

Abstract

Background: The interaction between IBD and psychosocial health is poorly understood. The prevalence of depression in IBD is three times higher than in the general population. Objective: We assessed the prevalence of and risk factors for developing depression in a tertiary care outpatient setting. A secondary objective was to assess adherence to recommended depression screening. Methods: We collected data from patients seen in the outpatient IBD clinic at the MedStar Georgetown University Hospital (MGUH) from August 2017 to March 2018. All patients were supposed to be screened for depression with the patient health questionnaire (PHQ-2). A score of score ≥3 was consistent with depression and prompted the provided to complete a PHQ-9 questionnaire. Patients who were under the age of 18 years were excluded. Results: We included 201 (CD) patients and 169 (UC) patients who had PHQ-2 data available. Only 55% (370 of 676) of patients had a documented PHQ-2 score. The prevalence of depression in this study was 3% (11 of 370). There were no significant differences observed between CD and UC patients in regards to gender, age, disease duration, race, or presence of depression. Depression did not vary based on disease severity (p=0.13 for CD, p=0.62 for UC). Conclusions: The prevalence of depression in this cohort is less than in the general population (6.7%). The majority of patients had CD, smoke, have an ostomy, had IBDrelated surgery, and were in remission. Patients with depression should be identified early and referred for therapy, because left untreated, depression can lead to aggressive disease.

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“…[1][2][3][4][5][6] The incidence of co-existing mood disorders is high in this patient population, yet many of these patients may not be adequately treated. [7][8][9][10][11][12] It has been reported in the literature that depression is three times more prevalent in people with IBD than in the general population. 1 A review by Neuendorf et al, 13 found that of 171 relevant studies using the Hospital Anxiety and Depression Scale (HADS) or the Beck Depression Inventory (BDI) the pooled estimate of depression in patients with IBD was 20.5%.…”

“…Much of what we know about depression and IBD is based on cross-sectional data 10,19 and only two prospective studies have assessed changes in disease activity in IBD patients with depression. 11,20 We aimed to assess the compliance of practitioners with depression screening of all patients seen in an outpatient, tertiary care, IBD clinic. Of the cohort that was screened, we aimed to assess the prevalence of depression and risk factors that contributed to the development of depression.…”

Sintomas depressivos em pacientes com doença de Crohn e sua relação com o fenótipo da doença

“…Além disso, há relatos que as mulheres, a idade avançada e os tabagistas estão mais propensos a desenvolverem depressão (94,115,116) . No entanto, outros autores, discordam da influência dessas variáveis clínicas como fator de risco para depressão, em indivíduos com DII (76,77,106) .…”

“…Neste estudo, não foram observadas diferenças significativas entre os pacientes com DC e RCU. Os autores relataram também que não houve diferenças significativas entre os pacientes com DC e RCU em relação a sexo, idade, duração da doença, raça ou presença de depressão, e o estado depressivo não se alterou com a gravidade da doença (76) . Em outra meta-análise, cinco estudos prospectivos com pequena casuística, as evidências foram limitadas para garantir uma associação entre depressão e DC ou RCU (77) .…”

“…Na última década é notório o aumento no número de pesquisas publicadas em todo o mundo, relacionando a depressão com DII. No entanto, não há um consenso sobre a prevalência de depressão em indivíduos com DC (68,72,76,77,79) .…”