Depression not linked to IBD risk in absence of previous GI symptoms

  • Blackwell J & al.
  • Gut
  • 27 Oct 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Individuals with ulcerative colitis (UC) or Crohn’s disease (CD) had a higher prevalence of depression in the years prior to inflammatory bowel disease (IBD) diagnosis.
  • Depression in the absence of prior gastrointestinal (GI) symptoms was not associated with future diagnosis of IBD.
  • However, individuals who experienced GI symptoms before the onset of depression were at a higher risk of receiving a diagnosis of either UC or CD.

Why this matters

  • Findings suggest that depression in combination with persistent GI symptoms may represent undiagnosed IBD.

Study design

  • This nested case-control study included 10,829 cases of UC and 4531 cases of CD and 15,360 matched controls using data from the UK Clinical Practice Research Datalink.
  • Funding: IBD Research Programme at Crohn’s & Colitis UK.

Key results

  • Individuals with IBD had an excess of prevalent depression 5 years before diagnosis relative to controls (UC: 3.7% vs 2.7%; CD: 3.7% vs 2.9%).
  • Individuals with depression and previous GI symptoms were at a higher risk of UC (adjusted OR [aOR], 1.47; 95% CI, 1.21-1.79) and CD (aOR, 1.41; 95% CI, 1.04-1.92) vs those without depression.    
  • Individuals with depression and without prior GI symptoms had a similar risk of UC (OR, 1.13; 95% CI, 0.99-1.29) and CD (OR, 1.12; 95% CI, 0.91-1.38) vs those without.

Limitations

  • Directionality and causality between depression and IBD were not tested.