Mood disorders in inflammatory bowel disease: Relation to diagnosis, disease activity, perceived stress, and other factors
Abstract
BACKGROUND: Anxiety and depression are common in patients with inflammatory bowel disease (IBD); however, the factors associated with mood disorders in patients with ulcerative colitis (UC) and Crohn's disease (CD) are poorly defined. METHODS: In all, 103 patients with UC, 101 with CD, and 124 healthy controls completed the Hospital Anxiety and Depression Scale (HADS). Disease activity was defined both from symptom scores and in UC endoscopically, and in CD by fecal calprotectin and/or serum C-reactive protein. Multivariate regression analyses were used to identify factors associated with anxiety and depression. RESULTS: In both UC and CD, anxiety (HADS-A) and depression (HADS-D) scores were higher than in controls (HADS-A: 8.5 ± 4.1 [mean ± SD], 8.6 ± 3.9, 3.2 ± 1.8, P < 0.001; and HADS-D: 4.1 ± 3.3, 4.7 ± 3.3, 1.7 ± 1.4, P < 0.001, respectively). There were no differences in the prevalence of mild, moderate, and severe anxiety and depression in UC and CD. In UC, anxiety scores were associated with perceived stress and a new diagnosis of IBD; depression was associated with stress, inpatient status, and active disease. In CD, anxiety was associated with perceived stress, abdominal pain, and lower socioeconomic status, and depression with perceived stress and increasing age. CONCLUSIONS: Anxiety and depression are common in IBD. Perceived stress is associated with mood disturbances in both UC and CD, but the other associated factors differ in the two diseases. Gastroenterologists should look for mood disorders in IBD and consider stress management and psychotherapy in affected patients.
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Nine of 13 studies found significantly higher rates and/or levels of depression in IBD participants than in healthy controls.
“Nine found significantly higher rates and/or levels of depression in IBD participants than in healthy controls (n=3,517 IBD; n=12,212 controls) (9, 15, 16, 19-22, 24, 26).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [20]
Eleven of 13 studies measuring anxiety in controversy 1 found significantly higher rates or levels of anxiety in IBD than in healthy controls.
“Eleven of the 13 studies measured anxiety, with seven of these reporting either significantly higher rates (% or levels (mean scores) of anxiety in those with IBD than in healthy control participants (n=3,262 IBD; n=12,024 controls) (9, 15, 20-22, 24, 26).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [20]
Of 15 studies with applicable data, 11 reported significantly higher rates or levels of anxiety in active IBD compared to inactive IBD.
“Of the remaining 15, 11 reported significantly higher rates or levels of anxiety in participants with active IBD compared to those with inactive IBD (n=13,585) (4, 18, 20, 27, 29, 31, 38, 41, 42, 44, 45).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [20]
Of 17 studies with applicable data, 12 reported significantly higher rates or levels of depression for active IBD compared to inactive IBD.
“Of the remaining 17 studies, 12 reported significantly higher rates or levels of depression for those with active IBD (n=13,553) (18, 20, 27, 29, 31, 34, 35, 38, 41, 43, 45, 48).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [20]
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“…scale (HADS; Bernstein et al., 2018) negatively impacts on physical health, with these patients demonstrating lowered adherence to treatment (Goodhand et al., 2012), increased disease activity (Kochar et al., 2018; Mikocka-Walus et al., 2016b), more hospitalisations (Allegretti et al.,…”
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- Authors
- Goodhand, J. R., Wahed, M., Mawdsley, J. E., Farmer, A. D., Aziz, Q., & Rampton, D. S.
- Affiliations
- Queen Mary University of London (GB)
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-12
- Volume
- 18
- Issue
- 12
- Pages
- 2301-2309
- ISSN
- 1078-0998 (ISSN-L)
- OpenAlex
- W2068853760
- Cited by
- 234
- References
- 16
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 18 · 2023: 16 · 2022: 14 · 2021: 18 · 2020: 21 · 2019: 21 · 2018: 22 · 2017: 24 · 2016: 22 · 2015: 14 · 2014: 16 · 2013: 8 · 2012: 7
- FWCI
- 8.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Inflammatory Bowel Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- inflammatory bowel disease, ulcerative colitis
- MeSH terms
- Adult, Anxiety, Colitis, Ulcerative, Crohn Disease, Cross-Sectional Studies, Depression, Feces, Female, Humans, Male, Psychiatric Status Rating Scales, Surveys and Questionnaires, Regression Analysis, Risk Factors, Stress, Psychological, Inflammatory Bowel Diseases, Case-Control Studies, Mood Disorders, Leukocyte L1 Antigen Complex
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