Depression, anxiety tied to higher health care use with inflammatory bowel disease

Worsening or persistently high anxiety or depression symptoms are tied to significantly higher use of health care among patients with inflammatory bowel disease (IBD), according to a study published in the February issue of the American Journal of Gastroenterology.

Keeley Fairbrass, M.B.Ch.B., from University of Leeds in the United Kingdom, and colleagues assessed trajectories of mental health symptoms in IBD. The analysis included self-reported and health care utilization data from 1,031 adult outpatients with IBD.

The researchers found that patients with worsening or persistently abnormal anxiety or depression scores had increased antidepressant (28.6 versus 12.3 percent and 35.8 versus 10.1 percent for anxiety and depression, respectively) and opiate use (19.0 versus 7.8 percent and 34.0 versus 7.4 percent for anxiety and depression, respectively) compared with patients with persistently normal or improving scores.

Individuals with worsening or persistent symptoms were also more likely to have been diagnosed with IBD in the last 12 months and to have clinically active disease at baseline and lower quality-of-life scores. Furthermore, significantly more outpatient appointments, radiological investigations, and endoscopic procedures for IBD-related symptoms were required for individuals with worsening or persistently abnormal trajectories of anxiety or depression.

"Based on our findings, there is a clear need to offer formal psychological support to a subgroup of patients with IBD, through a defined referral pathway, to reduce health care utilization and, potentially, improve disease prognosis," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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