Economic and humanistic burden of comorbid depression among individuals with irritable bowel syndrome in the non-institutionalized US adult population

AIM: This study estimated the incremental burden of comorbid depression on healthcare resource utilization (HCRU) and costs, functional limitations, health-related quality of life (HRQoL), and missed workdays, among adults with irritable bowel syndrome (IBS). METHODS: This cross-sectional study used 2016-2021 Medical Expenditure Panel Survey data to identify adults with IBS, with or without comorbid depression. The incremental effect of comorbid depression on HCRU was assessed using negative binomial models, while healthcare cost components were examined using generalized linear and two-part models. Functional limitations were assessed using logistic regression. Multivariable linear and negative binomial regression models were used to compare HRQoL (physical [PCS] and mental [MCS] component summary scores) and missed workdays, respectively, between groups. RESULTS: The sample included 1,422,146 (unweighted = 746) adults with IBS in the US, of whom 33.40% had depression. After adjusting for covariates, individuals with IBS and comorbid depression had significantly higher HCRU and costs across all categories than those without. Comorbid depression was significantly associated with greater odds of functional limitations. The mean MCS score was significantly lower among individuals with comorbid depression (mean difference: -14.80; 95% CI: -19.90 to -9.71), while no significant difference was observed in PCS. Individuals with comorbid depression reported 4.99 more missed workdays (95% CI: 4.64-5.36), compared to those without depression. CONCLUSIONS: Comorbid depression is associated with higher HCRU and costs, greater functional impairment, poorer mental HRQoL, and more missed workdays, among individuals with IBS. Targeted screening and better management of depression may improve outcomes in this population.