Affective psychiatric disorders are among some of the most commonly encountered disorders in clinical practice and their effects on medication compliance and patient disease perception are often underestimated. Inflammatory Bowel Disease (IBD) is a chronic illness that often requires strict medication adherence to reach and maintain remission status and concurrent mood disorders may limit physicians' ability to effectively manage these patients. It is common knowledge that there is a slightly greater prevalence of affective disorders among females in the general population, but how does this correspond to patients with IBD? This study evaluated the rate of comorbid psychiatric disorders in female as compared to male patients with IBD.Methods:
A retrospective chart review of IBD patients seen at an urban university medical center over a 6-month period was conducted to evaluate the associations between gender, ethnicity, IBD diagnosis (Crohn's Disease versus Ulcerative Colitis) and psychiatric history (depression, anxiety, PTSD). Exclusion criteria included presence of psychiatric medication prescription without documented psychiatric diagnosis. All included patients were under the care of faculty gastroenterologists. A Microsoft Excel database maintaining subject confidentiality was created. Statistical analysis was conducted using a 2-tailed Fisher's Exact Test with a significance set at P < 0.05.Results:
A total of 271 patient charts were reviewed, of which, 266 were included in the analysis. The patient population was comprised of 116 (43.6%) males and 150 (56.4%) females, with a mean age of 43.1 years. Ulcerative colitis accounted for 110 (41.4%) diagnoses and Crohn's disease for 156 (58.6%). The study included 141 (53%) Caucasians, 81 (30.5%) African Americans, 6 (2.3%) Latinos, 9 (3.4%) Asians, and 29 (10.9%) of other or undocumented ethnicity. A total of 43 (16.2%) patients had a comorbid psychiatric diagnosis. Of the 150 female IBD patients, 32 (21.3%) had concomitant psychiatric history. Of the 116 male IBD patients, 11 (9.5%) had a comorbid psychiatric diagnosis. There was a statistically significant increase in the prevalence of coexisting psychiatric disorders among women with IBD compared to men (P = 0.0113).Conclusions:
The presence of a coexisting psychiatric disorder among patients with IBD has serious implications on disease management, medication compliance, and patient perception of symptomatology. Data from recent literature estimates a 3-fold increase in noncompliance among depressed patients, further emphasizing the importance of identifying and addressing comorbid psychiatric conditions. Our data indicate a significant difference in the presence of concomitant psychiatric disorder between female and male IBD patients. This study supports the need for physicians to recognize psychiatric comorbidities in IBD patients to aid in management. Further research on the influence of psychiatric comorbidity in IBD is needed to optimize management.