Burden of depression and anxiety among patients with inflammatory bowel disease: results of a nationwide analysis

Tarar, Zahid Ijaz; Zafar, Muhammad Usman; Farooq, Umer; Ghous, Ghulam; Aslam, Aysha; Inayat, Faisal; Ghouri, Yezaz A.

doi:10.1007/s00384-021-04056-9

Cited by 17 publications

(23 citation statements)

References 42 publications

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“…Of interest, the inpatient mortality data of this study on initial evaluation may seem to contradict the findings of prior literature [ 15 ]. In Tarar et al, the aOR for inpatient mortality was 0.81 with a statistically significant p-value, demonstrating anxiety was protective in the setting of IBD [ 15 ]. In contrast, for this study, the mortality aOR was 1.87 indicating GAD is a risk factor for inpatient mortality in IBD patients.…”

Section: Discussioncontrasting

confidence: 90%

“…Prior studies revealed those with IBD and comorbid anxiety have more severe IBD presentations, lower quality of life, and increased length of hospital stay [ 15 , 19 ]. This study aimed to elucidate the outcomes of hospitalized IBD patients with comorbid GAD.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, for this study, the mortality aOR was 1.87 indicating GAD is a risk factor for inpatient mortality in IBD patients. The finding of anxiety being protective in Tarar et al may possibly be related to the general “anxiety” comorbidity used in that study, which can encompass different anxiety diagnoses, duration of symptoms, and severities [ 15 ]. It is possible that many of the IBD patients with “anxiety” may have had minimally severe anxiety, anxiety that was not persistent, or only short-term anxiety.…”

Section: Discussionmentioning

confidence: 99%

“…Also, it has been observed that patients with IBD and psychiatric comorbidity require more outpatient non-psychiatric physician visits, inpatient hospital days, and medications to treat IBD [ 14 ]. A study that evaluated the prevalence of anxiety among patients hospitalized for IBD found the prevalence of anxiety to be 39.3% higher in the IBD population [ 15 ]. This same study assessing anxiety prevalence among IBD patients also found that comorbid anxiety had decreased mortality rates, but longer hospitalizations [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…A study that evaluated the prevalence of anxiety among patients hospitalized for IBD found the prevalence of anxiety to be 39.3% higher in the IBD population [ 15 ]. This same study assessing anxiety prevalence among IBD patients also found that comorbid anxiety had decreased mortality rates, but longer hospitalizations [ 15 ]. Despite the increased prevalence of anxiety among IBD patients and the connection to worse symptoms, lower quality of life and higher use of healthcare resources, the impact of anxiety on hospital outcomes has not been thoroughly explored.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Inflammatory Bowel Disease in Hospitalized Patients With Generalized Anxiety Disorder

Kaye¹,

Patel²,

Meyers³

et al. 2022

Cureus

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BackgroundThe development of inflammatory bowel disease (IBD), which encompasses ulcerative colitis and Crohn's disease, is multifactorial. Stress from anxiety is a risk factor for IBD. Generalized anxiety disorder (GAD) is twice as likely in IBD patients. This study explores the outcomes of patients hospitalized for IBD with comorbid GAD. MethodsA retrospective analysis utilizing the 2014 USA National Inpatient Sample database was performed to assess the outcomes of hospitalized IBD patients with and without GAD. The outcomes analyzed were sepsis, acute hepatic failure, hypotension/shock, acute respiratory failure, acute deep vein thrombosis, acute renal failure, intestinal obstruction, myocardial infarction, ileus, inpatient mortality, colectomy, intestinal abscess, intestinal perforation, and megacolon. A multivariate logistic regression analysis was employed to explore whether GAD is a risk factor for these outcomes. ResultsAmong 28,173 IBD hospitalized patients in the study, GAD was a comorbid diagnosis in 3,400 of those patients. IBD patients with coexisting GAD were found to be at increased risk for acute hepatic failure (adjusted odds ratio (aOR) 1.80, p = 0.006), sepsis (aOR 1.33, p < 0.001), acute respiratory failure (aOR 1.24, p = 0.018), inpatient mortality (aOR 1.87, p < 0.001), intestinal abscess (aOR 2.35, p = 0.013), and intestinal perforation (aOR 1.44, p = 0.019). The aORs for the remaining outcomes were not statistically significant. ConclusionsIn hospitalized IBD patients, GAD is a risk factor for sepsis, acute hepatic failure, acute respiratory failure, intestinal abscess, intestinal perforation, and inpatient mortality. IBD and GAD are becoming increasingly common, which will likely lead to a larger number of complications among inpatients with these comorbidities.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Outcomes of Inflammatory Bowel Disease in Hospitalized Patients With Generalized Anxiety Disorder

Kaye¹,

Patel²,

Meyers³

et al. 2022

Cureus

View full text Add to dashboard Cite

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New insights into the interactions between the gut microbiota and the inflammatory response to ulcerative colitis in a mouse model of dextran sodium sulfate and possible mechanisms of action for treatment with PE&AFWE

Fu,

Ma,

et al. 2024

Anim Models and Exp Med

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BackgroundInflammatory bowel disease (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), is a heterogeneous state of chronic intestinal inflammation. Intestinal innate immunity, including innate immune cells, defends against pathogens and excessive entry of gut microbiota, while preserving immune tolerance to resident intestinal microbiota, and may be characterized by its capacity to produce a rapid and nonspecific reaction. The association between microbiota dysbiosis and the pathogenesis of IBD is complex and dynamic. When the intestinal ecosystem is in dysbiosis, the reduced abundance and diversity of intestinal gut microbiota make the host more vulnerable to the attack of exogenous and endogenous pathogenic gut microbiota. The aim of our study was to comprehensively assess the relationship between microbial populations within UC, the signaling pathways of pathogenic gut microbe therein and the inflammatory response, as well as to understand the effects of using PE&AFWE (poppy extract [Papaver nudicaule L.] and Artemisia frigida Willd. extract) on UC modulation.MethodsA UC mouse model was established by inducing SPF‐grade C57BL/6 mice using dextrose sodium sulfate (DSS). Based on metagenomic sequencing to characterize the gut microbiome, the relationship between gut microbiota dysbiosis and gut microbiota was further studied using random forest and Bayesian network analysis methods, as well as histopathological analysis.Results(1) We found that the 5 gut microbiota with the highest relative abundance of inflammatory bowel disease UC model gut microbiota were consistent with the top 5 ranked natural bacteria. There were three types of abundance changes in the model groups: increases (Chlamydiae/Proteobacteria and Deferribacteres), decreases (Firmicutes), and no significant changes (Bacteroidetes). The UC model group was significantly different from the control group, with 1308 differentially expressed species with abundance changes greater than or equal to 2‐fold. (2) The proportion of the fecal flora in the UC group decreased by 37.5% in the Firmicutes and increased by 14.29% in the proportion of Proteobacteria compared to the control group before treatment. (3) The significantly enriched and increased signaling pathways screened were the ‘arachidonic acid metabolic pathway’ and the ‘phagosomal pathway’, which both showed a decreasing trend after drug administration. (4) Based on the causal relationship between different OTUs and the UC model/PE&AFWE administration, screening for directly relevant OTU networks, the UC group was found to directly affect OTU69, followed by a cascade of effects on OTU12, OTU121, OTU93, and OTU7, which may be the pathway of action that initiated the pathological changes in normal mice. (5) We identified a causal relationship between common differentially expressed OTUs and PE&AFWE and UC in the pre‐ and post‐PE&AFWE‐treated groups. Thereby, we learned that PE&AFWE can directly affect OTU90, after which it inhibits UC, inhibiting the activity of arachidonic acid metabolic pathway by affecting OTU118, which in turn inhibits the colonization of gut microbiota by OTU93 and OTU7. (6) Histopathological observation and scoring (HS) of the colon showed that there was a significant difference between the model group and the control group (p < 0.001), and that there was a significant recovery in both the sulfasalazine (SASP)and the PE&AFWE groups after the administration of the drug (p < 0.0001).ConclusionWe demonstrated causal effects and inflammatory metabolic pathways in gut microbiota dysbiosis and IBD, with five opportunistic pathogens directly contributing to IBD. PE&AFWE reduced the abundance of proteobacteria in the gut microbiota, and histopathology showed significant improvement.

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Moving Towards Acceptance and Values: A Qualitative Study of ACTforIBD Compared to IBD Psychoeducation

Wilkin,

Evans,

Van Niekerk

et al. 2024

J Clin Psychol Med Settings

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The current study explored perspectives of those with inflammatory bowel disease (IBD) and comorbid anxiety and/or depression on a hybrid acceptance and committment therapy (ACT) intervention, compared to an active control. This qualitative study was nested within a randomized controlled trial (RCT) where an experimental group received an 8-week blended delivery ACTforIBD intervention (four sessions telehealth, four sessions pre-recorded self-directed), while an active control group received a psychoeducation program of similar intensity. Semi-structured interviews were conducted post-intervention and at a 3-month follow-up. Themes were interpreted using reflexive thematic analysis. Twenty individuals participated; ten in each condition. Seven themes were constructed, including three shared themes between groups: I Am Worth Advocating For, Present Moment Is My Biggest Ally, and Ambivalence About Self-Directed Modules. Two themes were identified for the ACTforIBD group: Symptoms Are Going to Happen and Moving Toward Values while two themes identified from the ActiveControl group were: Reset and Refresh and It’s Ok to Say No. Acceptance and values modules from ACTforIBD were perceived as useful in reducing psychological distress for those with IBD, while the ActiveControl group felt their program affirmed existing effective coping strategies. Access to external resources for self-directed modules and networking may increase engagement with content long term.

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Burden of depression and anxiety among patients with inflammatory bowel disease: results of a nationwide analysis

Cited by 17 publications

References 42 publications

Outcomes of Inflammatory Bowel Disease in Hospitalized Patients With Generalized Anxiety Disorder

Outcomes of Inflammatory Bowel Disease in Hospitalized Patients With Generalized Anxiety Disorder

New insights into the interactions between the gut microbiota and the inflammatory response to ulcerative colitis in a mouse model of dextran sodium sulfate and possible mechanisms of action for treatment with PE&AFWE

Moving Towards Acceptance and Values: A Qualitative Study of ACTforIBD Compared to IBD Psychoeducation

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