658 Epidemiology of Major Depressive Disorder, Anxiety Disorder, and Bipolar Disorder in Ulcerative Colitis in the United States Between 2014 and 2019: A Population-Based National Study

Abstract

INTRODUCTION: Studies have shown that patients with ulcerative colitis (UC) are at an increased risk for developing various psychiatric illnesses including major depressive disorder (MDD), anxiety disorder, and bipolar disorder. However, these studies have been limited by a small sample size. We aimed to describe the epidemiology of psychiatric illness in UC through utilization of a large sample population. METHODS: We queried a commercial database (Explorys Inc, Cleveland, OH), an aggregate of electronic health record data from 26 major integrated US healthcare systems. We identified an aggregated patient cohort of eligible patients with a diagnosis of UC and depression, anxiety, and bipolar disorder between 2014 and 2019 based on the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT). We also identified patients with a diagnosis of depression, anxiety, or bipolar disorder without UC. We calculated the overall prevalence of depression, anxiety, and bipolar disorder in UC amongst various patient groups. We also performed univariate analyses to identify risk factors for psychiatric illness in UC. RESULTS: Of the total number of patients in the database with UC, 22,780 had depression, 28,480 had anxiety, and 5,140 had bipolar disorder, with prevalences of 17%, 23%, and 4%, respectively. Depression, anxiety, and bipolar disorder in UC were more prevalent than in individuals without UC. Within UC, psychiatric illness was more prevalent in elderly (age >65 years old), females, and Caucasians. Compared to patients with psychiatric illness without UC, patients with psychiatric illness and UC were more likely to have a history of alcohol abuse, tobacco use, substance use, personality disorder, and corticosteroid use. CONCLUSION: This is one of the largest studies to date to describe the epidemiology of psychiatric illness in UC. Individuals with UC were more likely to suffer from depression, anxiety, and bipolar disorder compared to their non-UC counterparts. Prevalence of psychiatric illness in UC was more common in elderly, females, and Caucasians. Psychiatric illness is under recognized in UC and should be screened for and treated accordingly.