Relationship Between Depression and Severity in Inflammatory Bowel Disease

Background: Most studies that correlate Inflammatory Bowel Disease (IBD) with depression focus on identifying its prevalence, with few reviews relating the severity of depression to the severity of IBD, an important element in patients and sometimes underestimated despite being a relevant factor that could be related to the onset or worsening of symptoms. Objective: Determine the association between depression and the severity of IBD in patients evaluated in the gastroenterology service of the Vargas Hospital in Caracas. Since 1982 it has been known that 26% of patients with Ulcerative Colitis (UC) present some psychiatric disorder. In 1984 Addolorat et al. reported that more than 60% of patients with active IBD presented depression, is more frequent in patients with Crohn’s Disease (CD) than in those with UC. In Venezuela, a study carried out in 2018 found that 67% of patients presented some stressful event before the diagnosis of IBD; however, the association between the severity of the pathology and the patient’s mood was not evaluated. Methods: Observational, descriptive, and cross-sectional study where patients with a diagnosis of IBD from the gastroenterology service of the Vargas Hospital in Caracas (Venezuela) were evaluated by applying the Beck Depression Questionnaire in person for the subsequent multivariate data analysis in SPSS 24 system. Results: Of a total of 225 patients evaluated, 70% were female with an average age of 49 years, 81% were diagnosed with UC and 18% with CD, it was determined that 50% of patients with IBD present depression, thus diagnosed in 40% of cases with UC and 65% of patients with CD. Of these patients with depression, 43% of cases are diagnosed before 40 years of age. 51% are in relapse, 2% present extreme depression, 6% severe depression, 20% moderate depression, 13% clinical depression borderline, 16% mild mood alteration and 42% do not present depression while 70% of patients in remission are without depression. Conclusions: In the group evaluated, 50% of the patients with IBD present depression, with the majority experiencing a relapse of their disease, half of these were classified as moderate, severe, or extreme depression, which seems to be a factor associated with the severity of the IBD and more frequently among patients with CD; we recommend incorporating a psychologist and psychiatrist in all IBD multidisciplinary teams.