Study Finds Link Between Depression, Anxiety Symptoms and Disease Activity in IBD

stress, depression, anxiety
A team of investigators examined the association between disease activity in individuals with inflammatory bowel disease and the development of symptoms of depression and anxiety.

Elevated symptoms of depression and anxiety have been linked to active inflammatory bowel disease (IBD) over an extended period of time, according to the results of a study published in Inflammatory Bowel Diseases. For this reason, treatment addressing these comorbid conditions could be beneficial for the overall management of patients with IBD.

A group of investigators from the Canadian Institutes of Health Research (CIHR) conducted a longitudinal cohort study in which adult patients (N=247) with either Crohn disease (CD; n=153) or ulcerative colitis (UC; n=94) were assessed for symptoms of depression and anxiety in connection with disease activity level. The objective of the study was to improve upon previous research focused on IBD and its association with depression and anxiety that yielded inconsistent results.

Of the 247 people with IBD who were enrolled in the study, 216 completed 4 visits in a median follow-up period of approximately 3 years. Patients underwent abdominal examination, and information regarding IBD treatments was captured.  The patients completed the Hospital Anxiety and Depression Scale (HADS) questionnaire to assess symptom severity. Symptomatic IBD activity was measured by using the Powell Tuck Index for UC and the Harvey-Bradshaw Disease Activity Index for CD.

Approximately one-third of the individuals were found to be using biologic therapy at each visit, and one-third had active IBD at each visit. Participants with active IBD were at greater odds of having elevated symptoms of depression (odds ratio [OR], 6.27; 95% CI, 1.39-28.2) and anxiety (OR, 2.17; 95% CI, 1.01-4.66) compared with participants without active disease. Within individuals, elevated symptoms of depression were associated with increased odds of active IBD (OR, 2.70; 95% CI, 1.15-6.34); however, a similar correlation was not identified with elevated symptoms of anxiety.    

Although the study was limited by not capturing a biomarker of active inflammation and not documenting the use of prescription drugs for depression and anxiety, the researchers determined that there is a significant relation between active IBD and elevated symptoms of depression and anxiety. These findings highlight the importance of mental health screening and effect treatment for managing these comorbidities in patients with IBD.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Marie RA, Graff LA, Fisk JD, Patten SB, Bernstein CN; the CIHR Team in Defining the Burden and Mitigating the Impact of Psychiatric Comorbidity in Immuno-inflammatory Disease. The relationship between symptoms of depression and anxiety and disease activity in IBD over time. Inflamm Bowel Dis. Published online January 4, 2021. doi:10.1093/ibd/izaa349

This article originally appeared on Gastroenterology Advisor