Changing trends in coding for depression among the UK IBD population: reply from authors

We thank Blackwell et al1 for raising an important question about the classification of depression in a population of IBD patients in the UK. In our study,examining depression as a risk factor for the development of IBD,2 we chose to use a more restrictive case definition of depression based closely on a definition of major depressive disorder (MDD) as a clinically significant form of depression recognised in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)3 and known to be associated with a significant degree of morbidity and mortality.4 5 In contrast, we chose not to employ a case definition based on symptom codes, as these may or may not be clinically significant and may not be persistent over time. Since our objective was to investigate whether an exposure to MDD was associated with a significantly increased risk of IBD and  we were...

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