Psychological factors determine poor prognostic outcome in IBD

For adults with inflammatory bowel disease (IBD), psychological factors are an important determinant of poor prognostic outcome, according to a study published online March 23 in Gastroenterology.

Keeley M. Fairbrass, M.B.Ch.B., from St. James's University Hospital in Leeds, England, and colleagues examined the relative contribution of poor psychological health and clinical or biochemical activity to prognosis among 718 adults with IBD, with 6.5 years' follow-up.

The researchers found that individuals with clinical activity and symptoms of a common mental disorder had increased need for glucocorticoid prescription or flare, escalation, and death compared with clinical remission without symptoms of a common mental disorder at baseline (hazard ratios, 2.36, 1.65, and 4.99, respectively). The rates were not significantly higher for those with clinical remission and symptoms of a common mental disorder at baseline or for those with clinical activity without symptoms of a common mental disorder. Similarly, rates of glucocorticoid prescription or flare, escalation, hospitalization, and death were significantly higher among those with biochemical activity and symptoms of a common mental disorder (hazard ratios, 2.48, 2.97, 3.10, and 6.26, respectively).

"These data suggest that common mental disorders are a risk factor for a poor prognosis in IBD. Their presence should be screened for routinely and, if present, considered as a therapeutic target," the authors write.

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