{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T17:32:49Z","timestamp":1786555969618,"version":"build-2736575974"},"reference-count":30,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Center for Advancing Translational Sciences, National Institutes of Health","award":["UL1 TR002014"],"award-info":[{"award-number":["UL1 TR002014"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Patients with inflammatory bowel disease (IBD) who undergo multiple surgeries or stoma creation experience higher rates of anxiety and depression compared with patients with who have not undergone surgery. However, there are limited comparative data on short-term psychiatric outcomes in patients with IBD undergoing stoma-related IBD surgery vs nonstoma IBD surgery, specifically in patients treated with biologics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a population-based cohort study using TriNetX, of adults 18 to 65 years of age with newly diagnosed IBD between January 1, 2016, and December 31, 2019. Eligible patients had received biologic therapy and had no prior IBD-related surgeries or psychiatric diagnoses. Two cohorts were defined: (1) patients who underwent IBD-related surgery resulting in colostomy or ileostomy creation and (2) patients who underwent IBD-related surgery without ostomy creation. Incidence of depression, anxiety, and adjustment disorders was assessed using International Classification of Diseases\u2013Tenth Revision codes from postoperative day 1 up to 6\u2009months postsurgery. Variables were propensity score matched for the two cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1636 biologic-treated patients with IBD were included (818 per cohort). Comparing ostomy patients with nonostomy patients, depression occurred in 11.37% vs 6.24% (odds ratio [OR], 1.93; 95% confidence interval [CI], 1.35-2.76), anxiety occurred in 15.53% vs 11.98% (OR, 1.35; 95% CI, 1.02-1.79), and adjustment disorders occurred in 4.4% vs 2.57% (OR, 1.75; 95% CI, 1.01-3.02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall, ostomy creation was associated with greater short-term psychiatric morbidity in patients with IBD treated with biologics. Future research should explore specific factors that make this group of patients more vulnerable to anxiety and depression and aim to develop targeted mental health interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izag164","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:43:07Z","timestamp":1785159787000},"source":"Crossref","is-referenced-by-count":0,"title":["Short-term psychiatric outcomes after ostomy vs nonostomy surgery in biologic-treated IBD patients"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6956-155X","authenticated-orcid":false,"given":"Kofi","family":"Clarke","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine , Hershey, PA 17033,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Orbe","sequence":"additional","affiliation":[{"name":"Department of Medicine, Penn State College of Medicine , Hershey, PA 17033,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Dalessio","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine , Hershey, PA 17033,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey S","family":"Kulaylat","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery, Department of Surgery, Penn State College of Medicine , Hershey, PA 17033,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D","family":"Coates","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine , Hershey, PA 17033,","place":["United States"]},{"name":"Department of Neuroscience and Experimental Therapeutics, Penn State College of Medicine , Hershey, PA 17033,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"2026081212382606900_izag164-B1","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1111\/codi.14905","article-title":"Surgery, stomas, and anxiety and depression in inflammatory bowel disease: a retrospective cohort analysis of privately insured patients","volume":"22","author":"Sceats","year":"2020","journal-title":"Colorectal Dis"},{"key":"2026081212382606900_izag164-B2","doi-asserted-by":"publisher","first-page":"6496727","DOI":"10.1155\/2017\/6496727","article-title":"Prevalence of anxiety and depression in patients with inflammatory bowel disease","volume":"2017","author":"Byrne","year":"2017","journal-title":"Can J Gastroenterol Hepatol"},{"key":"2026081212382606900_izag164-B3","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1053\/j.gastro.2018.01.027","article-title":"Bi-directionality of brain-gut interactions in patients with inflammatory bowel disease","volume":"154","author":"Gracie","year":"2018","journal-title":"Gastroenterology"},{"key":"2026081212382606900_izag164-B4","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1136\/ebmental-2020-300223","article-title":"Prevalence of depression and anxiety in people with inflammatory bowel disease and associated healthcare use: population-based cohort study","volume":"24","author":"Irving","year":"2021","journal-title":"Evid Based Ment Health"},{"key":"2026081212382606900_izag164-B5","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1093\/ibd\/izae151","article-title":"Consensus statement on managing anxiety and depression in individuals with inflammatory bowel disease","volume":"31","author":"Hinnant","year":"2025","journal-title":"Inflamm Bowel Dis"},{"key":"2026081212382606900_izag164-B6","doi-asserted-by":"publisher","first-page":"2031","DOI":"10.1016\/j.cgh.2020.10.039","article-title":"Contemporary risk of surgery in patients with ulcerative colitis and Crohn\u2019s disease: a meta-analysis of population-based cohorts","volume":"19","author":"Tsai","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026081212382606900_izag164-B7","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1093\/ibd\/izab245","article-title":"Probability of stoma in incident patients with Crohn\u2019s disease in Sweden 2003-2019: a population-based study","volume":"28","author":"Everhov","year":"2022","journal-title":"Inflamm Bowel Dis"},{"key":"2026081212382606900_izag164-B8","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.4240\/wjgs.v16.i5.1235","article-title":"Surgical treatment of inflammatory bowel disease: from the gastroenterologist\u2019s stand-point","volume":"16","author":"Triantafillidis","year":"2024","journal-title":"World J Gastrointest Surg"},{"key":"2026081212382606900_izag164-B9","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1111\/iwj.13018","article-title":"Overview of psychosocial problems in individuals with stoma: a review of literature","volume":"16","author":"Ayaz-Alkaya","year":"2019","journal-title":"Int Wound J"},{"key":"2026081212382606900_izag164-B10","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1111\/jan.16254","article-title":"A scoping review of the qualitative literature reporting experiences of living with a stoma for inflammatory bowel disease","volume":"81","author":"Essex","year":"2025","journal-title":"J Adv Nurs"},{"key":"2026081212382606900_izag164-B11","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.12740\/PP\/62382","article-title":"Psychiatric illnesses in inflammatory bowel diseases - psychiatric comorbidity and biological underpinnings","volume":"50","author":"Nowakowski","year":"2016","journal-title":"Psychiatr Pol"},{"key":"2026081212382606900_izag164-B12","doi-asserted-by":"publisher","first-page":"S20","DOI":"10.12968\/bjon.2021.30.6.S20","article-title":"Psychological issues affecting patients living with a stoma","volume":"30","author":"Black","year":"2021","journal-title":"Br J Nurs"},{"key":"2026081212382606900_izag164-B13","doi-asserted-by":"publisher","first-page":"2537","DOI":"10.3390\/ijerph16142537","article-title":"Adjustment disorder: current developments and future directions","volume":"16","author":"O\u2019Donnell","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"2026081212382606900_izag164-B14","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1176\/appi.ajp.2016.16010071","article-title":"A longitudinal study of adjustment disorder after trauma exposure","volume":"173","author":"O\u2019Donnell","year":"2016","journal-title":"Am J Psychiatry"},{"key":"2026081212382606900_izag164-B15","doi-asserted-by":"publisher","first-page":"1568","DOI":"10.1097\/MIB.0000000000001201","article-title":"Clinical predictors of future nonadherence in inflammatory bowel disease","volume":"23","author":"Severs","year":"2017","journal-title":"Inflamm Bowel Dis"},{"key":"2026081212382606900_izag164-B16","doi-asserted-by":"publisher","first-page":"2496","DOI":"10.1053\/j.gastro.2021.04.022","article-title":"Aga clinical practice guidelines on the medical management of moderate to severe luminal and perianal fistulizing Crohn\u2019s disease","volume":"160","author":"Feuerstein","year":"2021","journal-title":"Gastroenterology"},{"key":"2026081212382606900_izag164-B17","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1053\/j.gastro.2024.10.001","article-title":"AGA living clinical practice guideline on pharmacological management of moderate-to-severe ulcerative colitis","volume":"167","author":"Singh","year":"2024","journal-title":"Gastroenterology"},{"key":"2026081212382606900_izag164-B18","doi-asserted-by":"publisher","first-page":"1773","DOI":"10.1136\/gutjnl-2021-325985","article-title":"Bidirectional brain-gut axis effects influence mood and prognosis in IBD: a systematic review and meta-analysis","volume":"71","author":"Fairbrass","year":"2022","journal-title":"Gut"},{"key":"2026081212382606900_izag164-B19","doi-asserted-by":"publisher","first-page":"17562848211033763","DOI":"10.1177\/17562848211033763","article-title":"Effects of anti-TNF therapy and immunomodulators on anxiety and depressive symptoms in patients with inflammatory bowel disease: a 5-year analysis","volume":"14","author":"Siebenh\u00fcner","year":"2021","journal-title":"Ther Adv Gastroenterol"},{"key":"2026081212382606900_izag164-B20","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1016\/j.cgh.2020.07.013","article-title":"Anxiety and depression leads to anti-tumor necrosis factor discontinuation in inflammatory bowel disease","volume":"19","author":"Dolovich","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026081212382606900_izag164-B21","doi-asserted-by":"publisher","first-page":"2658","DOI":"10.1097\/MIB.0000000000000930","article-title":"The impact of ostomy on quality of life and functional status of Crohn\u2019s disease patients","volume":"22","author":"Abdalla","year":"2016","journal-title":"Inflamm Bowel Dis"},{"key":"2026081212382606900_izag164-B22","doi-asserted-by":"publisher","first-page":"e0274665","DOI":"10.1371\/journal.pone.0274665","article-title":"Effect of closed and permanent stoma on disease course, psychological well-being and working capacity in Swiss IBD cohort study patients","volume":"17","author":"Bianchi","year":"2022","journal-title":"PLoS One"},{"key":"2026081212382606900_izag164-B23","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1111\/iwj.13076","article-title":"Depression and resilience in ulcerative colitis and Crohn\u2019s disease patients with ostomy","volume":"16 Suppl 1","author":"Hwang","year":"2019","journal-title":"Int Wound J"},{"key":"2026081212382606900_izag164-B24","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1186\/s12888-023-04871-0","article-title":"Depression after stoma surgery: a systematic review and meta-analysis","volume":"23","author":"Kovoor","year":"2023","journal-title":"BMC Psychiatry"},{"key":"2026081212382606900_izag164-B25","doi-asserted-by":"publisher","first-page":"e703","DOI":"10.1016\/j.cgh.2020.12.026","article-title":"Stoma formation in Crohn\u2019s disease and the likelihood of antidepressant use: a population-based cohort study","volume":"20","author":"Blackwell","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026081212382606900_izag164-B26","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.jpsychires.2022.10.052","article-title":"Outcomes and prognosis of adjustment disorder in adults: a systematic review","volume":"156","author":"Morgan","year":"2022","journal-title":"J Psychiatr Res"},{"key":"2026081212382606900_izag164-B27","doi-asserted-by":"publisher","first-page":"e15","DOI":"10.2196\/mental.4157","article-title":"Adjustment disorders are uniquely suited for ehealth interventions: Concept and case study","volume":"2","author":"Maercker","year":"2015","journal-title":"JMIR Ment Health"},{"key":"2026081212382606900_izag164-B28","doi-asserted-by":"publisher","first-page":"3017","DOI":"10.3390\/jcm13103017","article-title":"The surgical stress response and anesthesia: a narrative review","volume":"13","author":"Ivascu","year":"2024","journal-title":"J Clin Med"},{"key":"2026081212382606900_izag164-B29","doi-asserted-by":"publisher","first-page":"e471","DOI":"10.1016\/j.crohns.2013.02.022","article-title":"Relationship between health status, illness perceptions, coping strategies and psychological morbidity: a preliminary study with IBD stoma patients","volume":"7","author":"Knowles","year":"2013","journal-title":"J Crohns Colitis"},{"key":"2026081212382606900_izag164-B30","doi-asserted-by":"publisher","first-page":"149","DOI":"10.12669\/pjms.341.14108","article-title":"The effect of preoperative stoma site marking on quality of life","volume":"34","author":"Cakir","year":"2018","journal-title":"Pak J Med Sci"}],"container-title":["Inflammatory Bowel Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ibdjournal\/advance-article-pdf\/doi\/10.1093\/ibd\/izag164\/70619651\/izag164.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ibdjournal\/advance-article-pdf\/doi\/10.1093\/ibd\/izag164\/70619651\/izag164.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T16:38:32Z","timestamp":1786552712000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ibdjournal\/advance-article\/doi\/10.1093\/ibd\/izag164\/8759746"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":30,"URL":"https:\/\/doi.org\/10.1093\/ibd\/izag164","relation":{},"ISSN":["1078-0998","1536-4844"],"issn-type":[{"value":"1078-0998","type":"print"},{"value":"1536-4844","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"article-number":"izag164"}}