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Measuring Severity of Anxiety and Depression in Patients with Inflammatory Bowel Disease: Low Concordance Between Patients and Male Gastroenterologists

Janmohamed, Neha HBSc; Steinhart, A. Hillary MD, MSc

doi: 10.1097/MIB.0000000000001107
Original Clinical Articles

Background: Studies have indicated that anxiety and depression are significant contributors to reporting of increased disease activity in patients with inflammatory bowel disease (IBD). Thus, for the appropriate clinical management of these patients, it is important that gastroenterologists are able to recognize these conditions. This study aimed to examine the level of agreement between gastroenterologists and patients with IBD for the presence of clinically significant anxiety and depression.

Methods: Before consultation, patients completed the Hospital Anxiety and Depression Survey. After the consultation, the gastroenterologist recorded whether they believed the patient was anxious and depressed and if so, whether any further action had been taken.

Results: Seventy-five patients participated in this study, with a response rate of 88%. Self-reported questionnaires indicated that 31% and 11% of patients were identified as probable for having anxiety and depression, respectively. The level of agreement between the patient and gastroenterologist as to the presence of anxiety or depression was fair to moderate (kappa statistic 0.32 and 0.41, respectively). In only 50% of cases was further action taken by gastroenterologists during consultation for distressed patients, mostly in the form of a patient discussion.

Conclusions: Agreement between gastroenterologists and IBD patients regarding the presence of clinically significant anxiety or depression was low, with no further action taken after consultation for 50% of patients who were identified by gastroenterologists as being anxious or depressed. This study highlights the need for educating gastroenterologists to improve their ability to identify IBD patient distress.

Article first published online 29 May 2017.

Department of Gastroenterology, University of Toronto, Toronto, Ontario, Canada.

Address correspondence to: Neha Janmohamed, HBSc, Mount Sinai Hospital, 4th Floor, Room 445, 600 University Avenue, Toronto, ON M5G 1X5, Canada (e-mail:

A. H. Steinhart receives funding from Abbvie, Janssen, Takeda, Ferring, Allergan, Pharmascience, Shire, Merck, Hospira, and Pfizer. The remaining author has no conflict of interest to disclose.

A. H. Steinhart is a consultant for Abbvie, Janssen, Takeda, Ferring, Allergan, Pharmascience, Shire, Merck, Hospira, Pfizer.

Received October 16, 2016

Accepted February 22, 2017

© Crohn's & Colitis Foundation
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