AUTHOR=Joyees Jerlin , Marrie Ruth Ann , Bernstein Charles N. , Bolton James M. , Fisk John D. , Graff Lesley A. , Hitchon Carol , Patten Scott B. , Kowalec Kaarina , for the CIHR team in defining the burden and managing the effects of psychiatric comorbidity in chronic immunoinflammatory disease , Marrie Ruth Ann , Graff Lesley , Walker John R. , Hitchon Carol A. , Lix Lisa M. , Bolton James , Sareen Jitender , Katz Alan , Marriott James J. , Singer Alexander , El-Gabalawy Renée , Peschken Christine A. , Zarychanski Ryan , Bernstein Charles N. , Fisk John D. , Patten Scott B. , Berrigan Lindsay I. TITLE=Sex differences evident in elevated anxiety symptoms in multiple sclerosis, inflammatory bowel disease, and rheumatoid arthritis JOURNAL=Frontiers in Psychiatry VOLUME=14 YEAR=2023 URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1260420 DOI=10.3389/fpsyt.2023.1260420 ISSN=1664-0640 ABSTRACT=Introduction

Immune-mediated inflammatory diseases (IMID), such as multiple sclerosis (MS), inflammatory bowel disease (IBD) or rheumatoid arthritis (RA) have high rates of elevated anxiety symptoms. This can may worsen functioning and increase IMID disease burden. The rate of and factors associated with elevated anxiety symptoms may differ between males and females, which, in turn can affect diagnosis and disease management. We evaluated whether the frequency and factors associated with comorbid elevated anxiety symptoms in those with an IMID differed by sex.

Methods

Participants with an IMID (MS, IBD or RA) completed two anxiety measures (HADS, GAD-7). We used logistic regression to investigate whether sex differences exist in the presence of comorbid elevated anxiety symptoms or in the endorsement of individual anxiety items in those with an IMID.

Results

Of 656 participants, females with an IMID were more likely to have elevated anxiety symptoms compared to males (adjusted odds ratio [aOR] 2.05; 95%CI: 1.2, 3.6). Younger age, higher depressive symptoms and income were also associated with elevated anxiety symptoms in IMID. Lower income in males with an IMID, but not females, was associated with elevated anxiety symptoms (aOR: 4.8; 95%CI: 1.5, 15.6). No other factors demonstrated a sex difference. Males had nearly twice the odds of endorsing restlessness on the GAD-7 (OR = 1.8, 95%CI: 1.07, 3.15) compared to females.

Discussion

We found evidence for sex differences in the factors associated with experiencing elevated anxiety symptoms in those with an IMID. These findings could be helpful to sensitize clinicians to monitor for comorbid anxiety symptoms in males with an IMID.