P676 Burden of depression and anxiety among inflammatory bowel disease patients in a national cohort in Israel – Data from the EPI-IIRN
Mekori - Domachevsky, E..(1);Ziv - Baran, T.(2);Loewenberg Weisband, Y.(3);Greenfeld, S.(4);Kariv, R.(4);Erez, M.(5);Friss, F.(6);Focht, G.(6);Turner, D.(6);Ben - Horin, S.(1);Kopylov, U.(1);
(1)Sheba Medical Center, Gastroenterology Department, Ramat Gan, Israel;(2)Tel Aviv University, Department of Epidemiology and Preventive Medicine- School of Public Health- Sackler Faculty of Medicine, Tel Aviv, Israel;(3)Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel;(4)Maccabi Health Services, Medical Informatics Department, Tel Aviv, Israel;(5)Leumit Medical Services, Leumit Medical Services, Tel Aviv, Israel;(6)Shaare Zedek Medical Center, Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Jerusalem, Israel; IIRN
Background
Depression and anxiety in inflammatory bowel disease (IBD) patients have been receiving much deserved attention in recent years, as consecutive studies demonstrated that these emotional disorders are both common and detrimental for IBD patients. The aim of the current study was to examine the prevalence of depression and anxiety in a national cohort of IBD patients in Israel.
Methods
The epi-IIRN is a validated cohort of all IBD patients in Israel, ensured in four health maintenance organizations (HMOs). In this historical cohort study we included data from three HMOs, encompassing ~85% of Israeli population, between December 1997 [TD1] [UM2] and December 2019. Data included demographic data (age, sex and socioeconomic status), medical data (diagnosis type, time of diagnosis, medical regiments) and mental health status (a diagnosis of depression / anxiety defined by the relevant ICD9 codes or use of antidepressants / anxiolytics for at least two year quarters). For each IBD patient identified, three non-IBD subjects were allocated. Patients younger than 18 years or with a diagnosis of depression / anxiety preceding the diagnosis of IBD were excluded. Using cox regression and Kaplan Meier survival curve, we evaluated the prevalence of comorbid depression / anxiety at 5, 10 and 15 years following the diagnosis of an IBD.
Results
A total of 31340 IBD patients (48.1% females, mean age at diagnosis 38.6±15.9) and 91535 controls (48.7% females, mean age 39.9±16.1) were identified. The risk of depression / anxiety comorbidity was higher in IBD patients in comparison to controls at all evaluated timepoints: At 5 years following a diagnosis of IBD the hazard risk ratio (HR) was 1.48 (95% CI 1.43 – 1.53, p < 0.001, 15.5% vs 10.6%,); at 10 years HR was 1.38 (95% CI 1.34 – 1.42, p < 0.001, 22.9% vs. 17.0%) and at 15 years 1.37 (95% CI 1.33 – 1.40, p < 0.001, 27.5% vs 21.0%). For all analyses, female gender was a risk factor for development of depression/anxiety (HR~1.5, p < 0.001). IBD type (Crohn’s disease / ulcerative colitis) was not significantly associated with the risk of comorbid depression / anxiety.
Conclusion
Our national study highlights the substantial burden of depression and anxiety in IBD patients that is persistent for up to 15 years after diagnosis. Our findings emphasize the need to monitor for potential symptoms of depression and anxiety among our patients, as well as the need for prompt intervention and follow-up by a mental health care provider when such symptoms are identified.