title: Similar risk of depression and anxiety following surgery or hospitalization for Crohn's disease and ulcerative colitis.
abstract: OBJECTIVE
  Psychiatric comorbidity is common in Crohn's disease (CD) and ulcerative colitis (UC). Inflammatory bowel disease (IBD)-related surgery or hospitalizations represent major events in the natural history of the disease. The objective of this study is to examine whether there is a difference in the risk of psychiatric comorbidity following surgery in CD and UC.
  
  
  METHODS
  We used a multi-institution cohort of IBD patients without a diagnosis code for anxiety or depression preceding their IBD-related surgery or hospitalization. Demographic-, disease-, and treatment-related variables were retrieved. Multivariate logistic regression analysis was performed to individually identify risk factors for depression and anxiety.
  
  
  RESULTS
  Our study included a total of 707 CD and 530 UC patients who underwent bowel resection surgery and did not have depression before surgery. The risk of depression 5 years after surgery was 16% and 11% in CD and UC patients, respectively. We found no difference in the risk of depression following surgery in the CD and UC patients (adjusted odds ratio, 1.11; 95% confidence interval, 0.84-1.47). Female gender, comorbidity, immunosuppressant use, perianal disease, stoma surgery, and early surgery within 3 years of care predicted depression after CD surgery; only the female gender and comorbidity predicted depression in UC patients. Only 12% of the CD cohort had ≥4 risk factors for depression, but among them nearly 44% subsequently received a diagnosis code for depression.
  
  
  CONCLUSIONS
  IBD-related surgery or hospitalization is associated with a significant risk for depression and anxiety, with a similar magnitude of risk in both diseases.
authors: Crohn's and Colitis Center, Division of Gastroenterology, Massachusetts General Hospital, Boston, MA 02114, USA. aananthakrishnan@partners.org
authors: Ashwin N
authors: AN
authors: Ananthakrishnan
authors: Vivian S
authors: VS
authors: Gainer
authors: Tianxi
authors: T
authors: Cai
authors: Raul Guzman
authors: RG
authors: Perez
authors: Su-Chun
authors: SC
authors: Cheng
authors: Guergana
authors: G
authors: Savova
authors: Pei
authors: P
authors: Chen
authors: Peter
authors: P
authors: Szolovits
authors: Zongqi
authors: Z
authors: Xia
authors: Philip L
authors: PL
authors: De Jager
authors: Stanley
authors: S
authors: Shaw
authors: Susanne
authors: S
authors: Churchill
authors: Elizabeth W
authors: EW
authors: Karlson
authors: Isaac
authors: I
authors: Kohane
authors: Roy H
authors: RH
authors: Perlis
authors: Robert M
authors: RM
authors: Plenge
authors: Shawn N
authors: SN
authors: Murphy
authors: Katherine P
authors: KP
authors: Liao
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications / Q000523:psychology / Q000601:surgery*; D003424:Crohn Disease / Q000150:complications / Q000523:psychology / Q000601:surgery*; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors; D012737:Sex Factors