Depression Not Linked to IBD Risk in Absence of Previous GI Symptoms

Sarfaroj Khan 


November 02, 2020


  • Individuals with ulcerative colitis (UC) or Crohn’s disease (CD) had a higher prevalence of depression in the years prior to inflammatory bowel disease (IBD) diagnosis.

  • Depression in the absence of prior gastrointestinal (GI) symptoms was not associated with future diagnosis of IBD.

  • However, individuals who experienced GI symptoms before the onset of depression were at a higher risk of receiving a diagnosis of either UC or CD.

Why this matters

  • Findings suggest that depression in combination with persistent GI symptoms may represent undiagnosed IBD.

Study design

  • This nested case-control study included 10,829 cases of UC and 4531 cases of CD and 15,360 matched controls using data from the UK Clinical Practice Research Datalink.

  • Funding: IBD Research Programme at Crohn’s & Colitis UK.

Key results

  • Individuals with IBD had an excess of prevalent depression 5 years before diagnosis relative to controls (UC: 3.7% vs 2.7%; CD: 3.7% vs 2.9%).

  • Individuals with depression and previous GI symptoms were at a higher risk of UC (adjusted OR [aOR], 1.47; 95% CI, 1.21-1.79) and CD (aOR, 1.41; 95% CI, 1.04-1.92) vs those without depression.    

  • Individuals with depression and without prior GI symptoms had a similar risk of UC (OR, 1.13; 95% CI, 0.99-1.29) and CD (OR, 1.12; 95% CI, 0.91-1.38) vs those without.


  • Directionality and causality between depression and IBD were not tested.


Blackwell J, Saxena S, Petersen I, Hotopf M, Creese H, Bottle A, Alexakis C, Pollok RC. Depression in individuals who subsequently develop inflammatory bowel disease: a population-based nested case-control study. Gut. 2020 Oct 27 [Epub ahead of print]. doi: 10.1136/gutjnl-2020-322308. PMID: 33109601 View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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