Assessment of Comorbid Depression and Anxiety in Inflammatory Bowel Disease Using Adaptive Testing Technology. Issue 1 (6th February 2021)

• Record Type: Journal Article
• Authors: Karpin, Jordan E; Rodriguez, Tina G; Traboulsi, Cindy; Rai, Victoria; Gibbons, Robert D; Rubin, David T
• Is Part Of: Crohn's & colitis 360. Volume 3:Issue 1(2021)
• Publication Date: 2021-02-06
• Subjects: depression -- anxiety -- inflammatory bowel disease -- mental health -- comorbidities; Crohn's disease -- Periodicals; Colitis -- Periodicals; 616.344
• DOI: 10.1093/crocol/otaa095
• Languages: English
• ISSNs: 2631-827X

Abstract

Abstract: Background: Depression and anxiety are comorbidities of inflammatory bowel disease (IBD), and it is now recommended to screen IBD patients for these conditions. We screened patients using a novel computerized adaptive testing technology and compared the screening results to measures of disease activity. Methods: Consecutive patients at our tertiary IBD clinic were asked to complete the validated CAT-MH survey (Adaptive Testing Technologies, Chicago, IL); we then reviewed disease and patient characteristics. Clinical remission status was determined based on clinical, laboratory, endoscopy, and imaging results. Statistical methods included Fisher exact test and Pearson chi-square tests to assess association. Univariable and multivariable analyses were performed. Results: We included 134 patients, of which 34 (25.3%) screened positive for depression and 18 (13.4%) screened positive for anxiety. We identified 19 (55.9%) and 10 (55.5%) patients who were previously undiagnosed for depression and anxiety, respectively. Patients in clinical remission were less likely to screen positive for depression (odds ratio 0.19; 95% confidence interval 0.07–0.50) and for anxiety (odds ratio 0.30; 95% confidence interval 0.10–0.91). Compared to patients with negative C-reactive protein values, patients with positive C-reactive protein were more likely to also screen positive for depression ( P = 0.025) and anxiety ( P = 0.15). Conclusions: We demonstrate the utility of a novel testing technology for screening patients with IBD for depression and anxiety. We found a large number of patients with previously undiagnosed anxiety or depression and a significant positive association between clinically active IBD and these mental health conditions. This work supports and informs recommendations for mental health screening in the IBD population. Lay Summary: We demonstrate the utility of a novel rapid testing technology to screen patients with inflammatory bowel disease (IBD) for mental health comorbidities. We found that active IBD is a significant risk factor for depression/anxiety indicating the need for routine mental health screening.