title: Association of Inflammatory Bowel Disease (IBD) with Depressive Symptoms in the United States Population and Independent Predictors of Depressive Symptoms in an IBD Population: A NHANES Study.
abstract: OBJECTIVE
  There is a paucity of population-based studies on the association between inflammatory bowel disease (IBD) and depression in the U.S. population. We sought to study this association using the National Health and Nutrition Examination Survey (NHANES) database.
  
  
  METHODS
  We used NHANES data from 2009 to 2010. Our study included 190,269,933 U.S. adults without IBD and 2,325,226 with IBD. We sought to determine whether IBD is an independent risk factor for depressive symptoms (DS) in the U.S. population and studied the independent predictors of DS in IBD population.
  
  
  RESULTS
  DS was present in 49% of the IBD population versus 23% of the non-IBD population (p<0.001). During the multivariate analysis, we found that IBD was independently associated with DS in the U.S. population (p=0.002). The independent predictors of DS in the IBD population were older age (p=0.048) and divorced/separated/widowed status (p=0.005). There was nonsignificant increase in suicidal risk in IBD population with DS versus that in non-IBD population with DS (27% vs 12%, respectively, p=0.080). Only 36% of IBD individuals with DS visited mental health professional or psychiatrist within the past year.
  
  
  CONCLUSIONS
  IBD is independently associated with DS in the U.S. population. Further research is warranted on risk stratification, screening and management of those with IBD who are at risk of depression.
authors.affiliation: Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Bhandari
authors.affiliation: Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Larson
authors.affiliation: Division of Gastroenterology and Hepatology, Aurora St. Luke's Medical Center, Milwaukee, WI, USA.
authors.forename: Nilay
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Stein
mesh_terms: D000328:Adult; D000367:Age Factors; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Depressive; Inflammatory bowel disease; National survey; Population; United States