Prevalence of mental health disorders in inflammatory bowel disease: an Australian outpatient cohort

Abstract

Davina Tribbick,1 Michael Salzberg,2,3 Maria Ftanou,2,4 William R Connell,5 Finlay Macrae,6,7 Michael A Kamm,5,6,8 Glen W Bates,1 Georgina Cunningham,5 David W Austin,9 Simon R Knowles1–3,6,7 1Faculty of Life and Social Sciences, Swinburne University of Technology, Melbourne, VIC, Australia; 2Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia; 3Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia; 4Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; 5Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia; 6Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, VIC, Australia; 7Department of Medicine, University of Melbourne, Melbourne, VIC, Australia; 8Imperial College, London, UK; 9Department of Psychology, Deakin University, Melbourne, VIC, Australia Background: This study aimed to characterize prevalence of anxiety and depressive conditions and uptake of mental health services in an Australian inflammatory bowel disease (IBD) outpatient setting. Methods: Eighty-one IBD patients (39 males, mean age 35 years) attending a tertiary hospital IBD outpatient clinic participated in this study. Disease severity was evaluated according to the Manitoba Index. Diagnosis of an anxiety or depressive condition was based upon the Mini-International Neuropsychiatric Interview and the Hospital Anxiety and Depression Scale. Results: Based on Hospital Anxiety and Depression Scale subscale scores >8 and meeting Mini-International Neuropsychiatric Interview criteria, 16 (19.8%) participants had at least one anxiety condition, while nine (11.1%) had a depressive disorder present. Active IBD status was associated with higher prevalence rates across all anxiety and depressive conditions. Generalized anxiety was the most common (12 participants, 14.8%) anxiety condition, and major depressive disorder (recurrent) was the most common depressive condition reported (five participants, 6.2%). Seventeen participants (21%) reported currently seeking help for mental health issues while 12.4% were identified has having at least one psychological condition but not seeking treatment. Conclusion: We conclude that rates of anxiety and depression are high in this cohort, and that IBD-focused psychological services should be a key component of any holistic IBD service, especially for those identified as having active IBD. Keywords: inflammatory bowel disease, psychological conditions, disease activity