Abstract Background Although ostomy surgery is associated with an improvement in health-related quality of life for many patients with refractory inflammatory bowel disease (IBD), significant psychosocial challenges remain, including adapting to new anatomy and equipment, fears of infection or recurrent inflammation, and struggles with social changes.1 Here, we report the prevalence of depressive and anxiety symptoms among patients with IBD with an ostomy treated in our tertiary care clinic. Methods We conducted a retrospective cohort study of adult patients with IBD treated in our tertiary care clinic and screened for depression and anxiety using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 scale (GAD-7), respectively, between March 2023 and May 2025. Mental health screening results, demographics, disease characteristics, symptomatic disease activity, and biochemical markers of inflammation were collected. Clinically active IBD was defined as Harvey-Bradshaw Index (HBI) 5 for Crohn’s disease and Simple Clinical Colitis Activity Index (SCCAI) 2 for ulcerative colitis. The Kruskal-Wallis test was used to compare the distribution of PHQ-9 and GAD-7 categories between the patients with and without an ostomy. Results A total of 379 patients with IBD (250 (66%) Crohn’s, 210 (55%) Female, 308 (81%) White, median age 42 (IQR 31-59)) were included. Rates of depressive symptoms among the entire cohort were categorized according to standard PHQ-9 scoring and are as follows: 231 minimal (60.9%), 95 mild (25.1%), 37 moderate (9.8%), 11 moderately severe (2.9%), and 5 severe (1.3%). Among the 33 patients with an ostomy, moderate depressive symptoms were more prevalent compared to those without an ostomy, although not statistically significant (21.2% vs. 8.7%, p = 0.23). Rates of anxiety symptoms among the entire cohort were categorized according to standard GAD-7 scoring and are as follows: 256 minimal (67.5%), 70 mild (18.5%), 34 moderate (9.0%), or 19 severe (5.0%). Mild anxiety symptoms were significantly more prevalent in patients with an ostomy compared to those without an ostomy (39.4% vs. 16.5%, p = 0.049). Conclusion We demonstrate increased prevalence of moderate depressive and mild anxiety symptoms in patients with IBD with an ostomy compared to those without an ostomy. These findings underscore the need for routine mental health screening among all patients with IBD, especially patients with an ostomy, to ensure timely evaluation by mental health professionals. Reference: 1. Starcevic A, Filipovic B, Mijac D, Popovic D, Lukic S, Glisic T, Milanovic M, Zivic R, Popovic VS, Aksic M. Evaluating Quality of Life in Surgically Treated IBD Patients: A Systematic Review of Physical, Emotional and Social Impacts. Medicina (Kaunas). 2025;61(9):1662. Conflict of interest: Light, Sophia W.: No conflict of interest Ms. Mcdermott, Alexandra: No conflict of interest Schmaus, Jennifer A.: No conflict of interest Bedell, Alyse R.: Grant support from Pfizer Rubin, David T.: Grant support: Takeda Pharmaceuticals Consultant: Abbvie, Abivax SA, Altrubio, Athos Therapeutics, Inc, Bristol-Myers Squibb, Celltrion, Connect BioPharma, Eli Lilly & Co., Genentech (Roche) Inc., Iterative Health, Janssen Pharmaceuticals, Johnson & Johnson, Merck & Co., Mirador, Odyssey Therapeutics, Pfizer, Sanofi, Spyre, Takeda Pharmaceuticals, Vedanta Biosciences, and Ventyx.
Light et al. (Thu,) studied this question.