The role of resilience in mitigating depression and anxiety in patients with inflammatory bowel diseases

Background: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), often triggers psychological distress. Resilience, the ability to adapt to stress and trauma, may mitigate the psychological effects of chronic illnesses. Aims: To determine whether higher psychological resilience is independently associated with reduced anxiety and depressive symptoms and whether it moderates the relationship between disease activity and these symptoms in IBD patients. Methods: In this cross-sectional study, the Connor-Davidson Resilience Scale and the Hospital Anxiety and Depression Scale were administered to IBD outpatients. The disease activity was assessed using the Harvey-Bradshaw Index for CD and the Clinical Mayo Score for UC. Results: A total of 458 patients were included. High resilience was associated with fewer symptoms of depression (β = −0.726,p < .01) and anxiety (β = −0.668,p < .01) in CD patients. Similar results were found among UC patients (depression: β = −0.602,p < .01; anxiety: β = −0.490,p < .01). In CD, higher disease activity was associated with more depressive symptoms (β =0.098,p = .030). Resilience moderated the association between CD activity and anxiety (β = −0.125, p = .011), whereas its moderating effect on depression did not reach statistical significance (β = −0.086, p = .059). Overall, disease severity was more strongly associated with higher levels of depression and anxiety symptoms among low resilience patients than among those with high resilience. Conclusions: Resilience may play a protective role against depression and anxiety symptoms potentially temper disease activity, making it a worthwhile focus in comprehensive IBD management, particularly in Crohn's disease. As a dynamic factor, these findings support integrating resilience-building interventions into personalized IBD care pathways.