Similar risk of depression and anxiety following surgery or hospitalization for Crohn's disease and ulcerative colitis


Ananthakrishnan AN, Gainer VS, Cai T, Perez RG, Cheng SC, Savova G, Chen P, Szolovits P, Xia Z, De Jager PL, et al. Similar risk of depression and anxiety following surgery or hospitalization for Crohn's disease and ulcerative colitis. The American journal of gastroenterology. 2013;108 :594-601.

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OBJECTIVES: Psychiatric comorbidity is common in Crohn's disease (CD) and ulcerative colitis (UC). Inflammatory bowel disease (IBD)-related surgery or hospitalizations represent major events in the natural history of the disease. The objective of this study is to examine whether there is a difference in the risk of psychiatric comorbidity following surgery in CD and UC. METHODS: We used a multi-institution cohort of IBD patients without a diagnosis code for anxiety or depression preceding their IBD-related surgery or hospitalization. Demographic-, disease-, and treatment-related variables were retrieved. Multivariate logistic regression analysis was performed to individually identify risk factors for depression and anxiety. RESULTS: Our study included a total of 707 CD and 530 UC patients who underwent bowel resection surgery and did not have depression before surgery. The risk of depression 5 years after surgery was 16% and 11% in CD and UC patients, respectively. We found no difference in the risk of depression following surgery in the CD and UC patients (adjusted odds ratio, 1.11; 95% confidence interval, 0.84-1.47). Female gender, comorbidity, immunosuppressant use, perianal disease, stoma surgery, and early surgery within 3 years of care predicted depression after CD surgery; only the female gender and comorbidity predicted depression in UC patients. Only 12% of the CD cohort had >/=4 risk factors for depression, but among them nearly 44% subsequently received a diagnosis code for depression. CONCLUSIONS: IBD-related surgery or hospitalization is associated with a significant risk for depression and anxiety, with a similar magnitude of risk in both diseases.


Ananthakrishnan, Ashwin NGainer, Vivian SCai, TianxiPerez, Raul GuzmanCheng, Su-ChunSavova, GuerganaChen, PeiSzolovits, PeterXia, ZongqiDe Jager, Philip LShaw, StanleyChurchill, SusanneKarlson, Elizabeth WKohane, IsaacPerlis, Roy HPlenge, Robert MMurphy, Shawn NLiao, Katherine PK08 AR060257/AR/NIAMS NIH HHS/K23 DK097142/DK/NIDDK NIH HHS/K24 AR052403/AR/NIAMS NIH HHS/P60 AR047782/AR/NIAMS NIH HHS/R01 AR049880/AR/NIAMS NIH HHS/R01 AR057108/AR/NIAMS NIH HHS/R01 AR059648/AR/NIAMS NIH HHS/R01-AR056768/AR/NIAMS NIH HHS/R01-AR059648/AR/NIAMS NIH HHS/U01 GM092691/GM/NIGMS NIH HHS/U01-GM092691/GM/NIGMS NIH HHS/U54 LM008748/LM/NLM NIH HHS/U54-LM008748/LM/NLM NIH HHS/Am J Gastroenterol. 2013 Apr;108(4):594-601. doi: 10.1038/ajg.2012.471. Epub 2013 Jan 22.