Anxiety Disorders Twice as Likely Among Inflammatory Bowel Disease Patients

Women and individuals who suffered childhood sexual abuse among most vulnerable IBD patients.

Beyond the numerous physical difficulties that come with inflammatory bowel disease (IBD), patients afflicted with the condition are also more likely to experience psychological issues as well.

A new study by the University of Toronto finds that patients with an IBD, such as Crohn’s disease or ulcerative colitis, face twice the odds of developing a generalized anxiety disorder during their lives compared with individuals without IBD.

“Patients with IBD face substantial chronic physical problems associated with the disease,” said lead author Esme Fuller-Thomson, Sandra Rotman Endowed Chair at the University of Toronto Factor-Inwentash Faculty of Social Work. “The additional burden of anxiety disorders makes life much more challenging so this ‘double jeopardy’ must be addressed.”

The study found women with IBD were highly susceptible to anxiety disorders, with the odds of a disorder 4 times more likely compared with men who have IBD.

The researchers analyzed a representative sample of more than 22,000 Canadians, with 269 respondents reporting a diagnosis of either Crohn’s disease or ulcerative colitis.

“The study draws attention to the need for routine screening and targeted interventions for anxiety disorders,” said study co-author Joanne Sulman. “Particularly among the most vulnerable patients with IBD: women, individuals who are in chronic pain, and those with a history of childhood sexual abuse.”

The results showed 6-fold odds for anxiety disorders among IBD patients with a history of childhood sexual abuse. Furthermore, patients who reported moderate or severe chronic pain had double the odds of anxiety disorders compared with individuals who have only mild or no chronic pain.

Researchers highlighted the link between physical and mental health in affecting overall wellness.

“We sometimes think of the two as if they are entirely separate entities but the reality is they are intimately linked,” said Patrick McGowan, assistant professor of biological sciences at the University of Toronto Scarborough who was not directly involved with the study. “Both involve genuine physical changes in the body and affect each other.”

The findings of the study indicate that negative life experiences and chronic anxiety may influence the stress response system to impact a variety of bodily processes, such as chronic inflammation.

“This study asks about the association between these processes, so we don’t know cause-and-effect, but treatment options are likely to expand if the options are broader than physical or mental health alone,” McGowan added.