Impact of Inflammatory Bowel Disease on Depression in U.S. Population and Independent Predictors of Depression in IBD Population: An NHANES Study

Abstract

Introduction: Inflammatory bowel disease (IBD) patients have been found to have high rates of psychiatric disorders, however there is paucity of population-based studies on the true impact of IBD on depression in US population. We sought to study the impact of depression on IBD patients and also identify independent predictors of depression in IBD population using NHANES database. Methods: We used data from 2009-2010 NHANES which is a cross-sectional study representative of US population. All adults of 20-69 years old were included. We first compared IBD and non-IBD population and sought to see if IBD is an independent risk factor for depression in US population. Then we tried to elicit the independent predictors of depression in IBD population. Results: After weighing for national estimate, our study included 190,269,933 US adults without IBD and 2,325,226 with IBD. Depression was present in 49% of IBD population verses 23% in non-IBD population (unadjusted OR: 3.1, 95% CI 1.6-6.1, p=51 vs 20-50: adjusted OR 3.1, 95% CI 1.01-9.70, p=0.05) and divorced/separated/widowed status (vs married/living together: adjusted OR 33, 95% CI 4-378, p=0.005). Ulcerative colitis had higher prevalence of depression than Crohn's disease on univariate analysis (53% vs 23%, unadjusted OR: 3.8, 95 % CI 1.9-7.5, p < 0.0001), but the difference in prevalence was non-significant on multivariate analysis (adjusted OR: 3.3,95 % CI 0.6-18.1, p=0.1). There was trend toward increased risk of suicide in depressed IBD population verses depressed non-IBD population (27% vs 12%, p=0.08).Figure 1Figure 2Figure 3Conclusion: Our study, based on the NHANES database, showed IBD patients to be at increased risk of depression over the general population. Contrary to the general population, we found that older age and divorced/separated/widowed status to be independent predictors of depression in IBD population. Our study also found a non-significant increase in suicide risk in depressed IBD population than that in depressed non-IBD population, which implies increased severity of depression in IBD patients.