Routine Mental Health Screening Gains Priority in IBD Care

At a session focused on the intersection of inflammatory bowel disease (IBD) and mental health, Jessica Salwen-Deremer, PhD, highlighted the critical need for consistent screening, early identification, and structured response strategies for anxiety and depression in patients with Crohn’s disease and ulcerative colitis. Her presentation underscored the growing recognition that.

Dr Salwen-Deremer is the director of Behavioral Medicine for Digestive Health at Dartmouth-Hitchcock Medical Center and assistant professor of Psychiatry & Medicine at the Geisel School of Medicine at Dartmouth.

She began by outlining current guideline-based expectations for mental health screening. The American Gastroenterological Association recommends that “all adult patients with IBD should be screened for depression and anxiety annually.” The American College of Gastroenterology mirrors this stance, advising screening at baseline and yearly thereafter. These aligned recommendations reflect robust evidence that mood disorders are significantly more prevalent in IBD populations and exert measurable influence on disease trajectory.

The relationship between IBD and mental health is bidirectional. Patients with IBD have an increased risk of anxiety, depression, and trauma-related symptoms, but psychological distress also heightens the risk of disease flares, surgeries, and hospitalizations. Dr Salwen-Deremer emphasized that the data consistently demonstrate that “depression impacts IBD course,” reinforcing the importance of incorporating mental health evaluation into routine clinical workflows.

Screening, she noted, must be followed by an actionable plan. A positive result should prompt acknowledgement, validation, and a concise explanation of why addressing mental health is clinically important. Dr Salwen-Deremer encouraged clinicians to prepare a brief, rehearsed message for these moments. As she described it, clinicians should “have an ‘elevator pitch’ for why treating mental health matters.” This communication serves to normalize the conversation, reduce stigma, and position mental health care as an essential extension of IBD management. Examples provided included statements such as, “It looks like mental health has been tough lately—would you be interested in some resources?” and “Thanks for completing those questionnaires—it looks like there are some areas of your life that aren’t going as well.”

Her recommended framework for this discussion includes three core elements: reassurance and validation, a clear description of how mental health affects IBD activity, and a brief explanation of gut-brain communication and how dysregulation contributes to symptoms. This approach helps patients understand that psychological symptoms are physiologic, interconnected, and clinically meaningful.

When patients screen positive, referral options should be readily available. Dr Salwen-Deremer provided practical avenues for connecting patients with mental health professionals, including the Association for Behavioral and Cognitive Therapies directory, Rome GI Psych resources, and state chapters of the American Psychological Association. She also highlighted the usefulness of PSYPACT authorization for expanding telehealth access across multiple states.

For gastroenterologists, the key takeaway is clear: structured, routine mental health screening is now a standard component of IBD care, supported by guidelines and justified by its impact on disease outcomes. Effective implementation requires not only selecting appropriate tools but also preparing clinicians to respond confidently and constructively when screens are positive. By integrating mental health assessment and referral pathways into IBD management, clinicians can address a major driver of morbidity and improve long-term disease control.

Reference
Salwen-Deremer J. I'm anxious about my patient's anxiety: No psychologist in sight. Presented at: 2025 AIBD Annual Meeting. December 8-10, 2025.