Inflammatory Bowel Disease and Rheumatoid Arthritis Comorbidities Associated With Increased Psychological Burden

Patients with inflammatory bowel disease (IBD) who received a subsequent rheumatoid arthritis (RA) diagnosis displayed evidence of increased psychological burden compared with patients who had IBD alone. These findings were presented during the Digestive Disease Week annual meeting, held virtually, from May 21-23, 2021.

Researchers from the Cleveland Clinic analyzed data from the multi-institutional database Explorys Inc. for this study. Patient data were collected at 26 healthcare systems in the United States between 2015 and 2020. Records were searched for instances of IBD. Diagnoses of depression and/or anxiety within 30 days of a novel RA diagnosis were assessed.

Among the 37,718,540 patient records, 0.73% (n=276,570) had IBD and among those patients, 3.39% (n=9380) received a diagnosis of comorbid RA.

The IBD alone and IBD with comorbid RA cohorts were diagnosed with depression (21.0% vs 84.1%), anxiety (20.5% vs 46.7%), or both (12.6% vs 36.4%), respectively.

The elevated prevalence for these psychological conditions indicated that patients with IBD and RA comorbidities were at increased risk for depression (odds ratio [OR], 7.22; 95% CI, 6.97-7.47; P <.0001), anxiety (OR, 1.25; 95% CI, 1.21-1.29; P <.0001), and comorbid depression and anxiety (OR, 2.29; 95% CI, 2.23-2.34; P <.0001).

This study may have been limited by restricting the search to RA alone. It remains unclear whether other rheumatic comorbidities are at increased risk for depression or anxiety among patients with IBD.

The study authors concluded that in addition to the well-established increased risk for immune-mediated diseases such as RA among patients with IBD (2-3 times the general population), patients with comorbid IBD and RA are at an increased risk for additional psychological comorbidities. These trends indicated additional studies are needed in order to evaluate the extent of psychological burden and to elucidate which interventions may be effective at reducing symptoms of depression and anxiety.

Reference

Padival R, Alkhayyat M, Saleh MA, Regueiro MD. Risk of depression and anxiety in patients with inflammatory bowel disease and co-morbid rheumatoid arthritis. Poster presented at: Digestive Disease Week Annual Meeting; May 21-23, 2021. Abstract Sa572.