August 07, 2025
2 min read
Key takeaways:
- More than half of adult patients with IBD had at least one psychiatric comorbidity.
- Just over a quarter of patients had more than one psychiatric disorder.
More than half of adults with inflammatory bowel disease have at least one psychiatric comorbidity, according to research published in Crohn’s & Colitis 360.
These findings highlight the importance of preventing and treating both IBD and psychiatric disorders in this patient population.
Data were derived from Cadogan K, et al. Crohns Colitis 360. 2025;doi:10.1093/crocol/otaf035.
Charles N. Bernstein
“This study shows how common any psychiatric comorbidity is in IBD, and that, in fact, even multiple psychiatric comorbidities are common in any one patient,” study author Charles N. Bernstein, MD, FRCPC, distinguished professor of medicine at Max Rady College of Medicine and director of the University of Manitoba IBD Clinical and Research Centre, told Healio. “This adds greatly to their overall health burden, and in some instances may lead to greater negative impact on their quality of life than their IBD-related symptoms.”
For more than two decades, research on psychiatric comorbidity has focused on depression and anxiety, Bernstein said. Little is known about the prevalence of other psychiatric disorders.
Bernstein and colleagues conducted a cross-sectional analysis of data from a prospective, 3-year longitudinal study of psychiatric comorbidities among adults with various immune-mediated inflammatory diseases, including multiple sclerosis, IBD and rheumatoid arthritis.
The researchers focused only on individuals with IBD (n = 154; 62% women; 63% Crohn’s disease) for their analysis.
Participants self-reported smoking status, physical comorbidities and other baseline characteristics, while trained individuals assessed lifetime psychiatric comorbidity via the Structured Clinical Interview for Diagnostic Statistical Manual of Mental Disorders (DSM)-IV Disorders. The researchers added questions pertaining to PTSD using DSM-5 criteria.
Symptomatic IBD disease activity was assessed using the Powell Tuck Index for Ulcerative Colitis and the Harvey Bradshaw Disease Activity Index for Crohn’s Disease.
Results showed that more than half (57%) of participants had at least one psychiatric comorbidity, and 27% had more than one. The most common condition was major depressive disorder (41.7%), followed by anxiety disorders (39.6%), substance use disorders (16.2%), PTSD (5.3%), obsessive-compulsive disorder (4.9%) and bipolar disorder (2%).
The researchers also found that certain combinations of psychiatric disorders occurred more often. Notably, among those with major depressive disorder and another psychiatric comorbidity, nearly half (49.1%) had a substance abuse disorder. Of those with at least one psychiatric comorbidity, more than 70% had major depressive disorder and an anxiety disorder.
“While depression and anxiety were the most common psychiatric disorders, other disorders like substance use disorder also occurred,” Bernstein said. “Any psychiatric disorders occurred in 57%, but more than one disorder occurred in just over a quarter of persons. Hence, there is a great need for gastroenterologists to address the potential for mental health issues with IBD patients, and for there to be mental health resources available for IBD patients.”
Results also showed that having at least one psychiatric comorbidity was significantly associated with current smoking status (P < .001) and higher IBD disease activity scores (P = .005).
The researchers acknowledged study limitations, including inability to define a temporal association between psychiatric comorbidities and disease activity and potential bias in the mental health interviews.
“It is unclear if the sample is biased, because potential participants knew we were doing a study about mental health and IBD,” he said. “It would be important to follow a large cohort of IBD patients and learn how often mental health disorders develop post-IBD diagnosis.”
For more information:
Charles N. Bernstein, MD, FRCPC, can be reached at charles.bernstein@umanitoba.ca.
Sources/Disclosures
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Disclosures:
Bernstein reports serving on advisory boards for AbbVie Canada, Amgen Canada, Bristol Myers Squibb Canada, Celltrion, Eli Lilly & Co. Canada, Fresenius-Kabi Canada, JAMP Pharmaceuticals, Janssen Canada, Organon Canada, Pendopharm Canada, Sandoz Canada, Takeda Canada and Pfizer Canada; receiving educational grants from AbbVie Canada, Boston Scientific, Eli Lilly & Co. Canada, Ferring Canada, Fresenius Kabi Canada, Janssen Canada, Pfizer Canada and Takeda Canada; serving on a speakers panel for AbbVie Canada, Janssen Canada, Eli Lilly & Co., Fresenius Kabi and Takeda Canada; and research funding from AbbVie Canada, Janssen Canada, Pfizer Canada and Takeda Canada. Please see the study for all other authors’ relevant financial disclosures.
