{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:27:37Z","timestamp":1793212057392,"version":"4.5.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018952","name":"Birmingham Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018952","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007013","name":"F. Hoffmann-La Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000350","name":"Guts UK Charity","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000350","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Gastroenterol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Inflammatory bowel disease (IBD) is linked with increased prevalence of mental health disorders (MHD), particularly anxiety and depression. How this influences treatment outcomes in the first year after diagnosis is poorly studied. The IBD disk is a patient-reported outcome measure that quantifies disease-associated disability. Our objectives were to determine if the disk can identify those at risk of adverse treatment outcomes during the first year after diagnosis and assess if it could accurately screen for significant mental health symptoms at IBD presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Patients with suspected IBD were seen in a rapid-access clinic. An IBD disk was completed upon first review, pre-diagnosis. A subgroup simultaneously completed the Hospital Anxiety and Depression scale (HADS). Repeat disks were completed after diagnosis, with 12-month outcomes collected prospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>188 patients completed a baseline IBD disk (97 Crohn\u2019s disease [CD], 91 Ulcerative colitis [UC]), 95 completed a simultaneous HADS and 82 completed a repeat disk after diagnosis and treatment. Pre-existing MHD were more frequent in CD. Pre-diagnosis, the IBD Disk \u2018Emotions\u2019 domain correlated with HADS depression (r<jats:sub>s<\/jats:sub>=0.607 p&amp;lt;.001), anxiety (r<jats:sub>s<\/jats:sub>=0.586 p&amp;lt;.001) and reliably identified HADS defined moderate-severe depression (Area under the curve [AUC] 0.873, 95% CI 0.804 \u2013 0.942). An \u2018Emotions\u2019 domain score \u22657 identified all patients meeting this HADS threshold (Sensitivity 100%, specificity 60.5%, Youden\u2019s index 0.601). The strength of discrimination fell post diagnosis (AUC 0.712, 95% CI 0.491 \u2013 0.932), with ongoing high \u2018Emotions\u2019 domain scores strongly linked to disease activity in both CD and UC. Elevated baseline disk scores in UC predicted the subsequent need for advanced therapies (p=0.019), persistent active disease at 12 months (p=0.023) and need for inpatient treatment (p&amp;lt;.001). In CD, elevated disk scores predicted need for advanced therapies (p=0.014) and persistent active disease (p=0.015), though an association with the need for surgical resection within 12 months was not statistically significant (p=0.064).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The IBD disk reliably screens for symptoms of depression and anxiety and identifies risk of adverse treatment outcomes at IBD presentation. Particularly in UC, higher disk scores at diagnosis could complement existing tools to better identify those who would benefit from early treatment escalation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fgstr.2025.1642061","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T04:13:47Z","timestamp":1757564027000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The IBD-disk accurately assesses disability and psychological burden at IBD diagnosis and predicts adverse outcomes in both UC and Crohn\u2019s disease during the first year of treatment: a prospective observational cohort study"],"prefix":"10.3389","volume":"4","author":[{"given":"Peter","family":"Rimmer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viorelia","family":"Stoica","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asima","family":"Javed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Hazel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Owusu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Regan-Komito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Cooney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif J.","family":"Iqbal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain","family":"Chapple","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Harvey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq H.","family":"Iqbal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.jpsychores.2016.06.001","article-title":"Depression and anxiety in patients with Inflammatory Bowel Disease: A systematic review","volume":"87","author":"Neuendorf","year":"2016","journal-title":"J Psychosom Res"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(21)00014-5","article-title":"Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis","volume":"6","author":"Barberio","year":"2021","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"B3","article-title":"Mental health and wellbeing in England: The Adult Psychiatric Morbidity Survey 2014","author":"McManus","year":"2016","journal-title":"NHS Digital"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17110","article-title":"The association between inflammatory bowel disease and mental ill health: a retrospective cohort study using data from UK primary care","volume":"56","author":"Umar","year":"2022","journal-title":"Alimentary Pharmacol Ther"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izad169","article-title":"Children and young adults with inflammatory bowel disease have an increased incidence and risk of developing mental health conditions: A UK population-based cohort study","volume":"30","author":"Cooney","year":"2024","journal-title":"Inflammatory Bowel Dis"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izae206","article-title":"The burden of psychiatric manifestations in inflammatory bowel diseases: A systematic review with meta-analysis","volume":"31","author":"Massironi","year":"2025","journal-title":"Inflammatory Bowel Dis"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-325985","article-title":"Bidirectional brain\u2013gut axis effects influence mood and prognosis in IBD: a systematic review and meta-analysis","volume":"71","author":"Fairbrass","year":"2022","journal-title":"Gut"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.07.025","article-title":"High perceived stress is associated with increased risk of ulcerative colitis clinical flares","volume":"21","author":"Sauk","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B9","doi-asserted-by":"publisher","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":"Evidence Based Ment Health"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2019-101323","article-title":"Inflammatory bowel disease psychological support pilot reduces inflammatory bowel disease symptoms and improves psychological wellbeing","volume":"12","author":"Eccles","year":"2021","journal-title":"Frontline Gastroenterol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1089\/heq.2020.0053","article-title":"Newly diagnosed patients with inflammatory bowel disease: the relationship between perceived psychological support, health-related quality of life, and disease activity","volume":"5","author":"Engel","year":"2021","journal-title":"Health Equity"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2019-101260","article-title":"Consensus standards of healthcare for adults and children with inflammatory bowel disease in the UK","volume":"11","author":"Kapasi","year":"2020","journal-title":"Frontline Gastroenterol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1136\/flgastro-2022-102094","article-title":"Understanding and managing psychological disorders in patients with inflammatory bowel disease: a practical guide","volume":"14","author":"Kok","year":"2023","journal-title":"Frontline Gastroenterol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.jphys.2018.04.003","article-title":"Clinimetrics: hospital anxiety and depression scale","volume":"64","author":"Beekman","year":"2018","journal-title":"J Physiother"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000001033","article-title":"Development of the IBD disk: A visual self-administered tool for assessing disability in inflammatory bowel diseases","volume":"23","author":"Ghosh","year":"2017","journal-title":"Inflammation Bowel Dis"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-300049","article-title":"Development of the first disability index for inflammatory bowel disease based on the international classification of functioning, disability and health","volume":"61","author":"Peyrin-Biroulet","year":"2012","journal-title":"Gut"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjaa244","article-title":"The IBD-disk is a reliable tool to assess the daily-life burden of patients with inflammatory bowel disease","volume":"15","author":"Tadbiri","year":"2021","journal-title":"J Crohns Colitis"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjaa100","article-title":"VALIDation of the IBD-disk instrument for assessing disability in inflammatory bowel diseases in a french cohort: the VALIDate study","volume":"14","author":"Le Berre","year":"2020","journal-title":"J Crohns Colitis"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjac190.0500","article-title":"P370 Correlation of the IBD Disk with intestinal ultrasound in patients with inflammatory bowel disease","volume":"17","author":"Katsaros","year":"2023","journal-title":"J Crohn\u2019s Colitis"},{"key":"B20","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/S0022-3999(01)00296-3","article-title":"The validity of the Hospital Anxiety and Depression Scale: An updated literature review","volume":"52","author":"Bjelland","year":"2002","journal-title":"J Psychosomatic Res"},{"key":"B21","doi-asserted-by":"publisher","first-page":"n972","DOI":"10.1136\/bmj.n972","article-title":"Accuracy of the Hospital Anxiety and Depression Scale Depression subscale (HADS-D) to screen for major depression: systematic review and individual participant data meta-analysis","volume":"373","author":"Wu","year":"2021","journal-title":"BMJ"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjy113","article-title":"ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications","volume":"13","author":"Maaser","year":"2019","journal-title":"J Crohns Colitis"},{"key":"B23","unstructured":"JASP (Version 0.18.3)[Computer software]\n          \n          \n          \n          2024"},{"key":"B24","unstructured":"Jamovi (version 2.6.26)[Computer software]"},{"key":"B25","doi-asserted-by":"crossref","unstructured":"cutpointr: Improved Estimation and Validation of Optimal Cutpoints in R\n          \n          \n            \n              Thiele\n              C\n            \n            \n              Hirschfeld\n              G\n            \n          \n          10.18637\/jss.v098.i11\n          J Stat Softw\n          98\n          2021","DOI":"10.18637\/jss.v098.i11"},{"key":"B26","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/1471-2105-12-77","article-title":"pROC: an open-source package for R and S+ to analyze and compare ROC curves","volume":"12","author":"Robin","year":"2011","journal-title":"BMC Bioinf"},{"key":"B27","unstructured":"An R Companion to Applied Regression\n          \n          \n            \n              Fox\n              J\n            \n            \n              Weisberg\n              S\n            \n          \n          Thousand Oaks CA\n          Sage\n          \n          2019"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2021.2022620","article-title":"The association between uncertainty and mental health: a scoping review of the quantitative literature","volume":"32","author":"Massazza","year":"2022","journal-title":"J Ment Health"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izx063","article-title":"Independent validation of a self-report version of the IBD Disability Index (IBDDI) in a population-based cohort of IBD patients","volume":"24","author":"Shafer","year":"2018","journal-title":"Inflammation Bowel Dis"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17148","article-title":"Earnings during adulthood in patients with childhood-onset inflammatory bowel disease: a nationwide population-based cohort study","volume":"56","author":"Malmborg","year":"2022","journal-title":"Alim Pharmacol Ther"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2023-102428","article-title":"Inflammatory Bowel Disease Disability Index is a valid and reliable measure of disability in an English-speaking hospital practice and predicts long-term requirement for treatment escalation","volume":"15","author":"Storan","year":"2024","journal-title":"Frontline Gastroenterol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2024.08.047","article-title":"Multidimensional patient-reported outcomes and quality of life at diagnosis of IBD: A population-based inception cohort study","volume":"23","author":"Attauabi","year":"2025","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.12.031","article-title":"STRIDE-II: an update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) initiative of the International Organization for the Study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD","volume":"160","author":"Turner","year":"2021","journal-title":"Gastroenterology"},{"key":"B34","doi-asserted-by":"publisher","first-page":"101990","DOI":"10.1016\/j.bpg.2025.101990","article-title":"Treatment targets in IBD: is it time for new strategies","volume":"77","author":"Fanizzi","year":"2025","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izad182","article-title":"Inflammatory bowel diseases-related disability: risk factors, outcomes, and interventions","volume":"30","author":"Tse","year":"2024","journal-title":"Inflammatory Bowel Dis"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.04.007","article-title":"Reduced unplanned care and disease activity and increased quality of life after patient enrollment in an inflammatory bowel disease medical home","volume":"16","author":"Regueiro","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1053\/j.gastro.2022.03.014","article-title":"Relative contribution of disease activity and psychological health to prognosis of inflammatory bowel disease during 6.5 years of longitudinal Follow-Up","volume":"163","author":"Fairbrass","year":"2022","journal-title":"Gastroenterology"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20873","article-title":"Depression and anxiety in inflammatory bowel disease: A review of comorbidity and management","volume":"15","author":"Graff","year":"2009","journal-title":"Inflammatory Bowel Diseases"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2025.05.019","article-title":"Appropriate use and complications of corticosteroids in inflammatory bowel disease: A comprehensive review","author":"Feuerstein","year":"2025","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-022-07505-9","article-title":"Impact of comorbid psychiatric disorders on healthcare utilization in patients with inflammatory bowel disease: a nationally representative cohort study","volume":"67","author":"Hill","year":"2022","journal-title":"Dig Dis Sci"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-021-06893-8","article-title":"A multicenter study of patient acceptability of the IBD disk tool and patient-reported disabilities","volume":"67","author":"Sharma","year":"2022","journal-title":"Dig Dis Sci"}],"container-title":["Frontiers in Gastroenterology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgstr.2025.1642061\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T04:13:49Z","timestamp":1757564029000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgstr.2025.1642061\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,11]]},"references-count":41,"alternative-id":["10.3389\/fgstr.2025.1642061"],"URL":"https:\/\/doi.org\/10.3389\/fgstr.2025.1642061","relation":{},"ISSN":["2813-1169"],"issn-type":[{"value":"2813-1169","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,11]]},"article-number":"1642061"}}