Mental Health Needs of Pediatric Patients With IBD Often Not Adequately Met

Pediatric patients with IBD demonstrated high levels of depression and/or anxiety during the COVID-19 pandemic.

Almost half of pediatric patients with inflammatory bowel disease (IBD) demonstrated mental health concerns during the COVID-19 pandemic with only one-fourth of these patients receiving combined treatment with psychotropic mediations and formal mental health services. These are the findings of a study presented at the Advances in Inflammatory Bowel Diseases (AIBD) 2022 conference, held from December 5 to 7, 2022, in Orlando, Florida.

Researchers at the University of Rochester Medical Center (URMC) in Minnesota conducted a retrospective chart review from 2020 to 2021 of 140 pediatric patients with IBD with 7 excluded due to lack of a clearly established IBD diagnosis. Most pediatric patients had Crohn disease (81%) followed by ulcerative colitis (19%), and most were male (56%) with a mean age of 11.2 years.

Of this cohort, almost half (43%) of pediatric patients with IBD also demonstrated at least 1 mental health concern during the study period. The most common mental health concerns involved either depression alone (67%), anxiety alone (3%), or a combination of depression and anxiety (30%).

The researchers reviewed the rate of mental health visits within the psychiatry, behavioral health, pediatric psychology, adolescent medicine, and social work departments as well as prescription of psychotropic medications, excluding prescriptions for chronic migraines, attention deficit disorder (ADD), and attention deficit hyperactivity disorder (ADHD).

… [T]hese findings suggest that more anxiety and depression screening is needed for pediatric IBD patients and that mental health services may be underutilized in the pediatric IBD population.

Overall, 36% of pediatric patients received prescriptions for psychotropic medications, most commonly hydroxyzine (53%), sertraline (33%), and fluoxetine (25%). Around 49% of children taking psychotropic medications did not receive formal mental health care services compared with only 24% who did.

The researchers observed that pediatric patients with psychiatric disorders exhibited more IBD-related symptoms at time of IBD diagnosis compared with children without any history of psychiatric disorders (P =.02).

Children with IBD seen at URMC during the COVID-19 pandemic had high levels of depression and/or anxiety, the researchers noted. Furthermore at the time of diagnosis, patients with increased IBD symptoms demonstrated increased rates of psychopathology.

The researchers concluded “… [T]hese findings suggest that more anxiety and depression screening is needed for pediatric IBD patients and that mental health services may be underutilized in the pediatric IBD population.”

References:

Patel M, Mathers E, Pescatello M, Saubermann L. An assessment of mental health needs in pediatric patients with inflammatory bowel disease (IBD) during the COVID-19 pandemic. Abstract presented at: AIBD 2022; December 5-7, 2022; Orlando, FL. Abstract 90.