Background Depression occurs in up to 21% of IBD patients and is associated with increased healthcare costs. Antidepressants (AD), used by nearly 29% of IBD patients, target stress and depression, functional intestinal and somatic symptoms. IBD-related perception of disease, healthcare utilization, quality of life and outcomes are associated with racial and socio-economic disparities. Determining clinical and epidemiological predictors of antidepressant use in IBD will help identify vulnerable populations and maximize healthcare delivery. Methods The medical database of a large, urban, teaching hospital in the Bronx, NY was searched retrospectively for all IBD patients during the time period 1/2006 to 5/2016 using ICD-9 and 10 billing codes. Along with epidemiological and admissions data, information on AD prescription was recorded. Logistic regression analysis, T-, and Chi-square tests were performed to determine predictors of AD use, rates of hospital admission of IBD patients on AD, and time trends of AD use in IBD, respectively. Results Of the 4549 IBD patients in the cohort, 499 (11%) were prescribed AD either within 30 days prior to or following IBD diagnosis. The odds of AD use by IBD patients were 1.38 times more likely in men (p=0.005) and 1.72 times more likely for individuals <40 years (p=0.0003). There was a significant increase in IBD-related hospital admissions in IBD patients on AD compared to those not on AD (p<0.0001) [Table]. AD use over time had been increasing from 2006 to 2014 but has a downward trend since then (p<0.05 for each time interval) [Image]. Conclusion The odds of AD use in IBD patients is more likely in men and younger persons. AD use is associated with an increase in IBD-related hospital admissions. While usage increased from 2006-2014, AD use has recently declined. While it is possible that changes in management of IBD during this period may have impacted AD use, further prospective studies are needed.
