Clin Gastroenterol. 2024 May-Jun;58(5):464-470. doi: 10.1097/MCG.0000000000001892.Epub 2023 Jul 21.

Charles N Bernstein ^1 2, Casandra Dolovich ^1 2, Madelaine Prichodko ¹, John D Fisk ³, Lesley A Graff ^2 4, Scott B Patten ⁵, James Bolton ^2 6, Carol Hitchon ^1 2, Ruth Ann Marrie ^1 2 7; CIHR Team in Defining the Burden and Managing the Effects of Immune-mediated Inflammatory Disease

Author information

¹Department of Internal Medicine.

²The University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, Winnipeg.

³Departments of Psychiatry, Psychology and Neuroscience, and Medicine, Nova Scotia Health, Dalhousie University, Halifax.

⁴Department of Community Health Sciences.

⁵Department of Clinical Health Psychology.

⁶Departments of Community Health Sciences and Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.

⁷Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg.

Abstract

Background: Psychiatric comorbidity is common in inflammatory bowel disease (IBD) and can negatively affect disease outcomes. We explored the perceived need for mental health care among persons with IBD.

Study: Persons with IBD completed self-report questionnaires, including the Hospital Anxiety and Depression Scale (HADS), and reported whether they wanted help with their mood. Each was also assessed using the Structured Clinical Interview for DSM-IV-TR Axis-I Disorders (SCIDs). We used logistic regression analyses to determine factors associated with the perceived need for mental health care.

Results: Of 245 participants, 28% met the criteria for a past diagnosis of depression or anxiety disorder by SCID, and nearly 23% met the criteria for a current diagnosis of depression or anxiety disorder. One-third (n = 74) reported a perceived need for mental health care. Among those meeting criteria for a current SCID diagnosis of depression or anxiety, only 58% reported needing mental health care. Need for mental health care was reported by 79% of persons currently treated for either depression or 71% treated for anxiety. Persons with a perceived need for mental health care had higher mean HADS for depression and HADS for anxiety scores and also higher IBD symptom activity scores. Of those reporting no perceived need for mental health care, 13% had a current diagnosis of depression or anxiety disorder by SCID; even fewer had symptoms of depression or anxiety.

Conclusions: Symptoms of depression or anxiety are more important than a formal diagnosis of depression or anxiety in predicting which persons with IBD will perceive a need for mental health care.