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Utilizing interventions to treat mental health impairments in patients suffering from immune-mediated inflammatory diseases, such as irritable bowel disease, multiple sclerosis, and rheumatoid arthritis, can aid in improving mental health.

Mental illnesses are prevalent among individuals suffering from immune-mediated inflammatory diseases (IMID), such as multiple sclerosis (MS), inflammatory bowel disease (IBD), and rheumatoid arthritis (RA); however, there is less focus on the mental health of individuals suffering from these IMIDs than on their mental health. 

This cross-sectional study demonstrated that more than half of IMID patients had flourishing mental health, indicating the potential for achieving positive mental health in such individuals. One out of ten participants exhibited low levels of mental health, which were strongly correlated with elevated levels of depression, anxiety, and pain. These findings are published in BMJ Open.

Baseline Characteristics of Study Participants

The study group comprised 598 participants, with the majority being female and White. All participants completed the Mental Health Continuum Short-Form (MHC-SF) questionnaire. The highest median age and the smallest population were observed for the RA patients, who also reported the highest median scores for pain effects. The IMB patients had the least likelihood of clinically significant elevation in the symptoms of depression, whereas lower limb function was worse among MS patients compared to the RA and IMB cohorts.

Prominent Factors Influencing Mental Health and Well-Being

Higher MHC-SF and subscale scores were associated with a higher education level and being partnered. A significant association was observed between improved health and decreased pain severity, lowered physical disability, and mitigated indications of depressive and anxious states. There were 339 patients with flourishing mental health and 42 with deteriorating mental health. In addition, 217 patients were identified as having moderate mental health.

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Determinants of Mental Health Status in Patients

Higher odds of patients reporting flourishing mental health were associated with older age, whereas lower odds were associated with a clinically significant increase in depression and anxiety symptoms, fatigue, and pain.

MHC-SF Scores and Pain, Depression, Anxiety, and Gender

On examination of the 50th percentile, higher MHC-SF scores were related to lower pain impact and depression and anxiety symptoms. The MHC-SF scores were significantly higher among women. Lower emotional, social, and psychological scores were associated with higher depression and anxiety symptoms. Lower and higher psychological well-being scores were associated with more significant pain impact and female gender, respectively.

The utilization of interventions targeting the treatment of mental health impairment in patients suffering from IMIDs can aid in the improvement of mental health since more than half of these patients exhibit flourishing mental health despite chronic conditions.


Almweisheer, S., Bernstein, C. N., Graff, L. A., Patten, S. B., Bolton, J., Fisk, J. D., Hitchon, C. A., Marriott, J. J., & Marrie, R. A. (2023). Well-being and flourishing mental health in adults with inflammatory bowel disease, multiple sclerosis and rheumatoid arthritis in Manitoba, Canada: a cross-sectional study. BMJ Open, 13(6), e073782. https://doi.org/10.1136/bmjopen-2023-073782