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We appreciate the thoughtful feedback and points raised by authors Moulton, Norton, Powell, Mohamedali and Hopkins regarding the temporality between depression and inflammatory bowel disease (IBD) diagnosis and recommendation to perform further sensitivity analyses.1 The authors correctly highlight that the prodromal effects of IBD, including fatigue and low mood, prior to diagnosis may mimic depression and therefore put temporality into question.2 Furthermore, the median time from Crohn’s disease symptom presentation to diagnosis is 9 months and 75% of patients are diagnosed within 2 years.3 In response, we have performed two sensitivity analyses restricting to observations with at least (1) 9 months between depression and IBD diagnosis and …
Contributors All authors equally contributed to writing the letter.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests GGK has received honoraria for speaking or consultancy from Abbvie, Janssen, Pfizer and Takeda. He has received research support from Janssen, Abbvie, GlaxoSmith Kline, Merck and Shire. He shares ownership of a patent: TREATMENT OF INFLAMMATORY DISORDERS, AUTOIMMUNE DISEASE AND PBC. UTI Limited Partnership, assignee. Patent 62/555,397. 7 September 2017.
Provenance and peer review Not commissioned; internally peer reviewed.
Patient consent for publication Not required.