Anxiety and depression remain undiagnosed in large portions of patients with inflammatory bowel disease, according to recent data.
Charles N. Bernstein, MD, of the University of Manitoba in Canada, and colleagues wrote that IBD can compound the effects of mental disorders, reducing quality of life and worsening the disease course of IBD.
“Despite the important implications of untreated mental illness, prior studies suggest that depression and anxiety disorders remain underdiagnosed in the IBD population,” they wrote. “Risk factors that contribute to missed diagnoses of mental illness are poorly understood.”
Researchers evaluated the prevalence of undiagnosed depression and anxiety by analyzing data from a cohort study of psychiatric comorbidity in immune-mediated disorders, including IBD.
Patients (n = 242) underwent a Structure Clinical Interview for DSM-IV-TR Axis I Disorders (SCID) to identify which patients met lifetime criteria for a diagnosis of depression or anxiety. Researchers classified patients as diagnosed or undiagnosed based on a participant report of a physician diagnosis. They also evaluated demographic and clinical factors for links to undiagnosed mental disorders.
Ninety-seven patients (40.1%) met the criteria for depression and 74 (30.6%) met the criteria for anxiety. Among those patients, approximately one-third of those with depression and about two-thirds of those with anxiety were undiagnosed.
Bernstein and colleagues found that men were more likely to have undiagnosed depressive disorder (OR = 3.36; 95% CI, 1.28–8.85), while non-white patients were less likely to have an undiagnosed anxiety disorder (OR = 0.17; 95% CI, 0.042–0.72).
“The personal impacts of an undiagnosed mental illness can be devastating, frustrating, and confusing for the affected person,” they wrote. “This study highlights the importance of screening for mental illness in the IBD population, using any of several validated instruments, 22 particularly in males and whites.” – by Alex Young
Disclosures: Bernstein reports being on advisory boards for AbbVie Canada, Ferring Canada, Janssen Canada, Napo Pharmaceuticals, Pfizer Canada, Shire Canada and Takeda Canada. He also reports receiving educational grants from AbbVie Canada, Janssen Canada, Pfizer Canada, Shire Canada and Takeda Canada. Additionally, he reports being on speakers’ panels for Ferring Canada, Medtronic Canada, Shire Canada and Takeda Canada. Please see the full study for all other authors’ relevant financial disclosures.