A groundbreaking retrospective cohort study conducted in Southwest China has unveiled significant correlations between depression, anxiety, and clinical outcomes among elderly inpatients suffering from digestive system diseases. This research provides pivotal insights into how mental health disorders, often overlooked in somatic illness management, can substantially worsen patient trajectories, leading to extended hospital stays, elevated costs, and increased complications.
The investigation involved 1,290 elderly patients aged 60 years and above, all admitted to a tertiary care hospital with primary digestive system ailments between 2018 and 2022. Utilizing the well-validated Hospital Anxiety and Depression Scale (HADS), researchers identified that approximately one-third of these patients exhibited clinically relevant anxiety symptoms, while over a third demonstrated depressive symptoms. These prevalence rates underscore the critical psychological burden borne by elderly patients navigating chronic digestive diseases.
Key findings from the study revealed that depression in this patient population was not merely a psychological footnote but a determinant factor influencing clinical outcomes. Patients with depressive symptoms experienced significantly longer hospitalizations—averaging 14.2 days compared to 11.3 days for non-depressed counterparts. This protracted length of stay translated directly into heightened healthcare expenditure, with hospitalization costs rising from an average of ¥10,800 to ¥12,300 in depressed patients.
Perhaps more alarming was the marked increase in complications among depressed inpatients. Rates of hospital-acquired infections surged from 20.8% in non-depressed patients to 29.5% in those with depression, while gastrointestinal bleeding likewise showed a dramatic uptick—from 11.6% to 19.1%. These complications not only jeopardize patient survival but also complicate treatment protocols, adding layers of complexity to clinical care management in an already vulnerable demographic.
Subgroup analyses further illuminated the nuanced interplay between anxiety symptoms and adverse outcomes. Elderly female patients aged 70 years and above presenting with anxiety symptoms faced a significantly higher risk of prolonged hospitalization, with an adjusted odds ratio of 2.35. This gender and age-specific vulnerability emphasizes the necessity for tailored mental health screening and interventions in hospital settings.
The multivariable logistic regression model employed identified critical factors independently associated with anxiety symptoms, including poor sleep quality, cognitive impairment, and the presence of digestive system tumors. These variables denote a complex biopsychosocial interrelationship, wherein physiological deterioration, cognitive decline, and psychological distress coalesce, marching in tandem to influence patient outcomes.
From a clinical perspective, these findings advocate for the integration of routine psychological assessments into the inpatient care protocols for elderly patients with digestive diseases. Early identification of depression and anxiety through standardized tools such as HADS can enable timely psychosocial interventions, potentially mitigating the cascade of prolonged admissions, inflated costs, and dangerous complications.
Moreover, the prominence of female patients above 70 years old as a high-risk group signals a demographic that may benefit immensely from targeted mental health resources. Interdisciplinary collaboration among gastroenterologists, psychiatrists, geriatricians, and nursing staff could foster comprehensive care models that address both the physical and psychological dimensions of patient health.
Healthcare systems, particularly in regions bearing similar demographic and disease burdens as Southwest China, might consider this study as an impetus to reassess their inpatient management strategies. Given the aging global population and the rising prevalence of chronic digestive diseases, acknowledging and addressing mental health comorbidities is crucial for elevating standards of care.
This research also prompts a deeper inquiry into the pathophysiological mechanisms linking depressive and anxious symptomatology with worse digestive disease outcomes. Potential neuroimmune and neuroendocrine pathways could underlie this association, presenting novel therapeutic targets that transcend conventional disease-focused treatments.
Mental health disorders in elderly patients have historically been underdiagnosed and undertreated within hospital settings due to overlapping somatic symptoms and stigma. By foregrounding the concrete impact of these conditions on tangible medical outcomes, this study challenges healthcare providers to dismantle such barriers and prioritize psychological wellness.
Furthermore, these findings resonate with broader global health initiatives advocating holistic care frameworks, underscoring that the mind and body are intricately connected in disease manifestation and recovery. The study’s data adds empirical vigor to this paradigm by demonstrating measurable adverse effects of psychiatric symptoms on hospital metrics and patient prognoses.
In conclusion, the retrospective cohort analysis from Southwest China delivers compelling evidence that anxiety and depression substantially influence clinical outcomes in elderly inpatients with digestive system diseases. Proactive psychological assessment and interventions are not luxuries but necessities to optimize patient recovery trajectories, reduce healthcare burdens, and improve quality of life in this susceptible population.
Subject of Research: Clinical impact of depression and anxiety symptoms on elderly inpatients with digestive system diseases in Southwest China
Article Title: The impact of depression and associated anxiety symptoms on clinical outcomes in elderly inpatients with digestive system diseases in Southwest China: a retrospective cohort study
Article References: Ren, D., Wang, X., Shen, H. et al. The impact of depression and associated anxiety symptoms on clinical outcomes in elderly inpatients with digestive system diseases in Southwest China: a retrospective cohort study. BMC Psychiatry 25, 585 (2025). https://doi.org/10.1186/s12888-025-07038-1
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