Early Mental Health Improvements Predict Long-Term Remission in UC
A recent study to evaluate the prognostic value of early mental health improvement in predicting long-term disease remission in patients with ulcerative colitis (UC) demonstrated a strong association between early mental health improvement and favorable long-term outcomes, investigators reported in The American Journal of Gastroenterology.
Recognizing the increasing relevance of psychosocial factors in chronic disease management, the authors investigated whether mental health changes during the early treatment phase could serve as a predictor of sustained clinical outcomes. The analysis was based on data from the SELECTION trial, which included 381 patients with UC receiving filgotinib.
Mental health was quantitatively measured using the mental health subscale of the 36-item Short-Form Survey (SF-36), and a response was defined as a score improvement of ≥7.85 by week 10. Multivariate logistic regression, adjusted for confounding variables, was used to estimate associations between early mental health changes and measures of disease remission assessed at week 58—including endoscopic, clinical, histologic remission, and complete disease clearance.
Patients who achieved the defined mental health response at week 10 were significantly more likely to reach endoscopic remission (adjusted odds ratio [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 full disease clearance (aOR 3.48; 95% CI: 1.74–7.50) by week 58.
Furthermore, predictive modeling revealed that the addition of mental health response metrics significantly enhanced the ability to forecast treatment success. Notably, patients who achieved clinical remission alone at week 10 were roughly half as likely to experience endoscopic remission at week 58 compared to those who achieved both clinical remission and a mental health response (aOR 0.45; 95% CI: 0.21–0.91).
The authors concluded, “Early mental health improvements independently predicted long-term disease remission. Integrating mental health assessments into UC management strategies may provide valuable insights beyond physical symptoms.”
Reference:
Zheng J, Huang P, Feng R, et al. Early improvement of mental health is associated with long-term disease remission in ulcerative colitis. Am J Gastroenterol. Published online July 7, 2025. doi:10.14309/ajg.0000000000003638
