Early Improvement of Mental Health Is Associated With Long-Term Disease Remission in Ulcerative Colitis.

Abstract

Emerging evidence highlight the critical role of mental health in the management of ulcerative colitis (UC). We investigated the relationship between early mental health improvement and long-term disease remission. This study used data from the SELECTION trial involving 381 patients treated with filgotinib. Mental health was assessed using the mental health subscale of the 36-item Short-Form Survey. Endoscopic, clinical, and histologic outcomes were assessed at week 58. Adjusted odds ratios (aOR) with 95% confidence intervals (95% CIs) were calculated using multivariable logistic regression. Receiver operating characteristic curves, combined with bootstrap resampling, were used to define the mental health response threshold. Early mental health improvements at week 10 were significantly associated with disease remission at week 58. Patients who showed a mental health response (subscale score changes of ≥7.85) exhibited greater odds of achieving endoscopic remission (aOR 2.67, 95% CI: 1.43-5.25), clinical remission (aOR 1.91, 95% CI: 1.22-2.99), histologic remission (aOR 1.98, 95% CI: 1.27-3.12), and disease clearance (aOR 3.48, 95% CI: 1.74-7.50). In addition, incorporating mental health response assessment along with clinical remission significantly enhanced outcome predictions. Specifically, individuals with only clinical remission at week 10 were approximately half as likely to reach week-58 endoscopic remission (aOR 0.45, 95% CI: 0.21-0.91) compared with those who attained both mental health response and clinical remission. Early mental health improvements independently predicted long-term disease remission. Integrating mental health assessments into ulcerative colitis management strategies may provide valuable insights beyond physical symptoms.