P311 Depression and anxiety are associated with poor clinical outcomes in Inflammatory Bowel Disease : A Nationwide Population-Based Study in South Korea

Kim, S.(1);Seungwoo, L.(2);Kyungdo, H.(2);Hyun Jung , L.(1);Jong Pil , I.(1);Joo Sung, K.(1);

(1)Seoul National University College of Medicine, Department of Internal Medicine and Liver Research Institute, Seoul, Korea- Republic Of;(2)Soongsil University, Department of Statistics and Actuarial Science, Seoul, Korea- Republic Of;


The increase in prevalence of depression and anxiety disorder in Inflammatory Bowel Disease (IBD) is demonstrated from previous studies, but it is uncertain whether the patients with depression and anxiety are at higher risk of poor outcomes of IBD. Therefore we aimed to determine the impact of depression and anxiety on clinical outcomes in patients with IBD.


We conducted a nationwide, population-based retrospective cohort study using the Korean national health insurance claims data between 2010 and 2017. Patients with Crohn’s Disease and Ulcerative Colitis were targeted through the registration program for rare/intractable diseases, and patients with depression and anxiety were also identified by the International Classification of Disease, tenth revision (ICD-10) code. The primary outcome of this study is the poor IBD-related outcomes and we defined the poor IBD-related outcomes as IBD-related emergency room visits, hospitalization, and surgery in this study.


A total of 36,379 IBD patients (10,754 Crohn’s disease (CD) and 25,625 ulcerative colitis (UC)) were enrolled in this study between 2010 and 2017 and among them, 4,335 (11.9%) had depression/anxiety. Multivariate analysis showed that CD patients with depression/anxiety were at an increased risk of ER visits (HR 1.858, 95% CI 1.5-2.301) and hospitalization (HR 1.727, 95% CI 1.315-2.269). UC patients with depression/anxiety were also at increased risk for ER visits (HR 1.339, 95% CI 1.084-1.654) and hospitalization (HR 1.367, 95% CI 1.059-1.764). While the risk of surgery in patients with depression/anxiety was not different from those without depression/anxiety in both CD and UC.


Depression and anxiety disorder was associated with a higher risk for poor clinical outcomes in patients with IBD. The results of this study suggest that psychologic co-morbidities such as depression and anxiety might improve the clinical course of IBD