Assessment of patients with inflammatory bowel disease (IBD) using the Patient Health Questionnaire-9 (PHQ-9) identified a higher rate of depression vs standard of care evaluation, according to research presented at the Advances in Inflammatory Bowel Diseases (AIBD) 2021 Annual Meeting, held from December 9 to 11, 2021, in Orlando, Florida and virtually.
There has been growing evidence to suggest that patients with IBD may be at increased risk for depression, due in part to the chronicity of symptoms coupled with treatment costs, missing school and work, and interpersonal relationship factors. Depressive symptoms among the IBD community have been found to occur at a rate of roughly 20%. Patients with more severe disease have been associated with a higher rate of depression (40.7% vs 16.5%). Depression has been associated with lower quality of life, decreased medication compliance, poor disease outcomes, increased hospitalization, and higher risk for suicide, making early diagnosis of depression critical for assuring prompt intervention.
For this prospective quality improvement study, investigators at the Henry Ford Health System in the United States compared rates of depression among a cohort of patients on the basis of medical history (n=60) vs a group of patients who were screened using the PHQ-9 during in-person visits (n=51) held from January to March 2020.
The rate of depression was 35% among the PHQ-9 group and 20% among the control group (P =.071). Stratified by symptoms, the rates were 15% among those with nonfistulizing Crohn disease and 41.4% for fistulizing Crohn disease (P =.003).
Predictors of depression included extra-intestinal manifestations of disease (odds ratio [OR], 3.06; 95% CI, 1.03-9.12; P =.045); patients with these manifestations were at higher risk for depression among the PHQ-9 cohort (OR, 3.30; 95% CI, 1.07-10.16; P =.038).
Age was a significant predictor for depression (OR, 0.97; 95% CI, 0.94-1.00; P =.042). The average age of a patient with and without depression was 38.3 and 47.1 years, respectively.
Investigators note their research was limited by the small sample size and thus may have been underpowered; however, this study was disrupted by the COVID-19 pandemic, limiting the ability of the investigators to recruit more patients.
These data underscore the importance of evaluating patients with IBD for depression using validated instruments, such that these symptoms may be identified in a timely manner, allowing for earlier intervention.
Ankita N, Armani P, Faisal N, et al. Impact of PHQ-9 screening on early identification of depression in IBD clinic. Presented at: AIBD 2021 Annual Meeting; December 9-11, 2021; Orlando, FL and virtual. Abstract P059.
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Source: Psychiatry Advisor