Clinical Predictors of Depression among Patients with Inflammatory Bowel Diseases: A Cross-sectional Analytical Study from Oman

OBJECTIVES: Many studies suggest that depression is prevalent among patients suffering from inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). Both depression and IBD have a significant disease burden. However, these studies have mostly been conducted among European and American populations and there is a paucity of studies from Arab countries. This study aimed to examine the prevalence and predictors of depressive symptoms among adult IBD patients attending a tertiary care hospital in Muscat, Oman.

METHODS: We conducted a cross-sectional study among a random sample of patients aged ≥ 18 years who attended the gastroenterology clinic at Sultan Qaboos University Hospital, Muscat, Oman, between June 2018 and January 2019. Participants were asked to complete the Patient Health Questionnaire-9, which is used to assess depression, and a sociodemographic survey. Logistic regression analysis was used to identify the independent predictors of depressive symptoms among the study sample. Adjusted odds ratios (aORs) were also reported.

RESULTS: This study included 201 participants, with an average age of 36 years. Just over half (51.2%) of participants were female. The mean duration of the patients' IBD diagnosis was 1.9±0.3 years, the majority (n = 174, 86.6%) of the participants had UC, 80.1% (n = 161) of the participants had received steroids, and 5.5% of the sample had a history of a surgical stoma. The medical comorbidities among the participants were cerebrovascular accidents (24.9%), hypertension (24.5%), and diabetes mellitus (23.9%). The prevalence of depressive symptoms was 23.4%. The logistic regression analysis resulted in four independent predictors of depression: being female (OR = 2.090, p = 0.047), history of surgical stoma (OR = 5.737, p < 0.001), comorbid diagnosis of hypertension (OR = 2.846, p = 0.007), and history of a cerebrovascular accident (OR = 2.651, p = 0.011).

CONCLUSIONS: Depressive symptoms are prevalent among Omani patients with IBD. Certain clinical factors appeared to increase the risk of depression among this population. The findings of this study fill a gap in the existing literature and call for further work aiming at screening and managing depression among IBD patients.