659 Epidemiology of Major Depressive Disorder, Anxiety Disorder, and Bipolar Disorder in Crohn's Disease in the United States Between 2014 and 2019: A Population-Based National Study

Abstract

INTRODUCTION: Studies have shown that patients with Crohn's disease (CD) are at an increased risk for developing various psychiatric illnesses including depression, anxiety, and bipolar disorder. However, these studies have been limited by a small sample size. We aimed to describe the epidemiology of psychiatric illness in CD 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 CD and depression, anxiety, and bipolar disorder between 2013 and 2018 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 CD. We calculated the overall prevalence of depression, anxiety, and bipolar disorder in CD amongst various patient groups. We also performed univariate analyses to identify risk factors for psychiatric illness in CD. RESULTS: Of the total number of patients in the database with CD, 28,640 had depression, 38,640 had anxiety, and 11,410 had bipolar disorder, with prevalences of 19%, 25%, and 8%, respectively. Depression, anxiety, and bipolar disorder in CD were more prevalent than in individuals without CD. Within CD, psychiatric illness was more prevalent in elderly (age >65 years old), females, and Caucasians. Compared to patients with psychiatric illness without CD, patients with psychiatric illness and CD 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 CD. Individuals with CD were more likely to suffer from depression, anxiety, and bipolar disorder compared to their non-CD counterparts. Prevalence of psychiatric illness in CD was more common in elderly, females, and Caucasians. Psychiatric illness should be actively screened for and treated accordingly in CD.