Faculty mentor/PI email address
Yschneid@virtua.org
Is your research Teaching and Learning based?
1
Keywords
Mental Health, Depression, Anxiety, IBD, Crohns, Ulcerative Colitis
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely affect biologic therapy outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti-TNF agents.
Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti-TNF agent between 2018–2023 were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to anti-TNF initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 9,605 patients per cohort. Primary outcomes included inpatient/ED encounters, abscess/fistula, all-cause mortality, and need for an alternative biologic. Secondary outcomes included steroid use, emotional symptoms, and colectomy. Risk ratios (RR) with 95% confidence intervals were calculated.
Results: Compared with IBD patients without mood disorders, those with depression/anxiety had significantly higher risks of inpatient/ED encounters (49.1% vs. 35.7%; RR 1.38), abscess/fistula (10.9% vs. 8.4%; RR 1.31), and mortality (1.8% vs. 1.3%; RR 1.35). Need for an alternative biologic was similar between groups (20.3% vs. 19.9%; RR 1.02, p=NS). Secondary outcomes were consistently worse in the mood disorder cohort, including steroid use (54.7% vs. 44.9%; RR 1.22), emotional symptoms (4.5% vs. 1.0%; RR 4.70), and colectomy (5.7% vs. 4.2%; RR 1.34).
Conclusions: Comorbid depression and anxiety in IBD patients receiving anti-TNF therapy are associated with significantly higher risks of hospitalization, abscess/fistula, and mortality, while biologic switching rates remain unchanged. Proactive mental health assessment and management should be integrated into comprehensive IBD care.
Disciplines
Digestive System Diseases | Medicine and Health Sciences | Psychiatric and Mental Health
Mental health comorbidities and IBD outcomes on anti-TNF therapy
Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely affect biologic therapy outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti-TNF agents.
Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti-TNF agent between 2018–2023 were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to anti-TNF initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 9,605 patients per cohort. Primary outcomes included inpatient/ED encounters, abscess/fistula, all-cause mortality, and need for an alternative biologic. Secondary outcomes included steroid use, emotional symptoms, and colectomy. Risk ratios (RR) with 95% confidence intervals were calculated.
Results: Compared with IBD patients without mood disorders, those with depression/anxiety had significantly higher risks of inpatient/ED encounters (49.1% vs. 35.7%; RR 1.38), abscess/fistula (10.9% vs. 8.4%; RR 1.31), and mortality (1.8% vs. 1.3%; RR 1.35). Need for an alternative biologic was similar between groups (20.3% vs. 19.9%; RR 1.02, p=NS). Secondary outcomes were consistently worse in the mood disorder cohort, including steroid use (54.7% vs. 44.9%; RR 1.22), emotional symptoms (4.5% vs. 1.0%; RR 4.70), and colectomy (5.7% vs. 4.2%; RR 1.34).
Conclusions: Comorbid depression and anxiety in IBD patients receiving anti-TNF therapy are associated with significantly higher risks of hospitalization, abscess/fistula, and mortality, while biologic switching rates remain unchanged. Proactive mental health assessment and management should be integrated into comprehensive IBD care.