Ananthakrishnan, AshwinGainer, V. S.Perez, R. G.Cai, T.Cheng, S.-C.Savova, G.Chen, P.Szolovits, P.Xia, Z.De Jager, P. L.Shaw, S. Y.Churchill, S.Karlson, E. W.Kohane, I.Perlis, R. H.Plenge, R. M.Murphy, S. N.Liao, K. P.2017-09-292013Ananthakrishnan, A. N., V. S. Gainer, R. G. Perez, T. Cai, S.-C. Cheng, G. Savova, P. Chen, et al. 2013. “Psychiatric Co-Morbidity Is Associated with Increased Risk of Surgery in Crohn’s Disease.” Alimentary Pharmacology & Therapeutics 37 (4) (January 7): 445–454. doi:10.1111/apt.12195.0269-2813http://nrs.harvard.edu/urn-3:HUL.InstRepos:33973668Introduction Psychiatric co-morbidity, in particular major depression and anxiety is common in patients with Crohn’s disease (CD) and ulcerative colitis (UC). Prior studies examining this may be confounded by the co-existence of functional bowel symptoms. Limited data exists examining an association between depression or anxiety and disease-specific endpoints such as bowel surgery. Methods Using a multi-institution cohort of patients with CD and UC, we identified those who also had co-existing psychiatric co-morbidity (major depressive disorder or generalized anxiety). After excluding those diagnosed with such co-morbidity for the first time following surgery, we used multivariate logistic regression to examine the independent effect of psychiatric co-morbidity on IBD-related surgery and hospitalization. To account for confounding by disease severity, we adjusted for a propensity score estimating likelihood of psychiatric co-morbidity influenced by severity of disease in our models. Results A total of 5,405 CD and 5,429 UC patients were included in this study; one-fifth had either major depressive disorder or generalized anxiety. In multivariate analysis, adjusting for potential confounders and the propensity score, presence of mood or anxiety co-morbidity was associated with a 28% increase in risk of surgery in CD (OR 1.28, 95% CI 1.03 – 1.57) but not UC (OR 1.01, 95% CI 0.80 – 1.28). Psychiatric co-morbidity was associated with increased healthcare utilization. Conclusion Depressive disorder or generalized anxiety is associated with a modestly increased risk of surgery in patients with CD. Interventions addressing this may improve patient outcomes.en-UShospitalizationsurgerydepressionulcerative colitisCrohn’s diseaseJournal Article2017-09-2220132017-09-2910.1111/apt.12195