{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:44:21Z","timestamp":1787773461594,"version":"build-2784847793"},"reference-count":59,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,3,9]],"date-time":"2025-03-09T00:00:00Z","timestamp":1741478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012536","name":"Leeds Hospital Charitable Foundation","doi-asserted-by":"publisher","award":["9R11\/14\u201002"],"award-info":[{"award-number":["9R11\/14\u201002"]}],"id":[{"id":"10.13039\/100012536","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Common mental disorders, including anxiety and depression, are prevalent in patients with inflammatory bowel disease (IBD) and may be associated with adverse outcomes. However, whether increasing psychological co\u2010morbidity, in combination with disease activity, exerts a cumulative effect on prognosis is uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess this in a longitudinal follow\u2010up study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected baseline demographic and IBD\u2010related information, clinical activity using disease activity scores and biochemical activity using calprotectin. Patients were grouped according to the presence or absence of disease activity. Patients in remission or with active disease were subgrouped according to the presence or absence of symptoms of a common mental disorder at baseline. We recorded the occurrence of adverse outcomes over 8.1\u2009years, comparing their occurrence across subgroups using Cox regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 717 participants with clinical activity data and 187 with clinical and biochemical activity data, rates of adverse outcomes increased with both disease activity and increasing psychological co\u2010morbidity. Rates of flare or glucocorticosteroid prescription, escalation or death were higher with clinical activity (HR 2.89; 95% CI 1.68\u20134.93 and 2.52; 95% CI 1.55\u20134.10 and 6.97; 95% CI 2.43\u201320.0, respectively) or clinical and biochemical activity (HR 7.26; 95% CI 2.86\u201318.5, 3.62; 95% CI 1.59\u20138.25 and 57.3; 95% CI 7.58\u2013433, respectively) and two common mental disorders. Rates of hospitalisation (HR 6.20; 95% CI 1.88\u201320.4) or hospitalisation and\/or intestinal resection (HR 7.46; 95% CI 2.41\u201323.2) were higher with clinical and biochemical activity and two common mental disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Psychological co\u2010morbidity and active disease have a cumulative adverse impact on IBD prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.70068","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T16:51:42Z","timestamp":1741625502000},"page":"1635-1648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Cumulative Impact of Clinical Disease Activity, Biochemical Activity and Psychological Health on the Natural History of Inflammatory Bowel Disease During 8\u2009Years of Longitudinal Follow\u2010Up"],"prefix":"10.1111","volume":"61","author":[{"given":"Christy","family":"Riggott","sequence":"first","affiliation":[{"name":"Leeds Gastroenterology Institute St. James's University Hospital  Leeds UK"},{"name":"Leeds Institute of Medical Research at St. James's University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5569-4762","authenticated-orcid":false,"given":"Keeley M.","family":"Fairbrass","sequence":"additional","affiliation":[{"name":"Leeds Gastroenterology Institute St. James's University Hospital  Leeds UK"},{"name":"Leeds Institute of Medical Research at St. James's University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Gracie","sequence":"additional","affiliation":[{"name":"Leeds Gastroenterology Institute St. James's University Hospital  Leeds UK"},{"name":"Leeds Institute of Medical Research at St. James's University of Leeds  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