PREVALENCE OF PSYCHOTROPIC MEDICATION USE AMONG PATIENTS WITH CHRONIC AND IMMUNE-MEDIATED DISEASES: A REAL-WORLD ANALYSIS USING EPIC COSMOS

Background

Psychiatric conditions frequently co-occur with chronic and immunemediated diseases; however, large-scale real-world data describing psychotropic medication use within these populations are limited. Characterizing psychotropic medication use across medically complex patient groups may help inform future studies of psychiatric comorbidity and prescribing patterns.

Methods

We conducted a retrospective, cross-sectional analysis using Epic Cosmos, a national de-identified electronic health record database, including encounters from October 10, 2022 through October 9, 2025. Adult patients with diagnoses of common variable immunodeficiency (CVID), type 1 diabetes mellitus (T1DM), rheumatoid arthritis, Crohn’s disease, ulcerative colitis, multiple sclerosis, systemic lupus erythematosus, and asthma were identified. Psychotropic medication use was defined as prescription of commonly used antidepressants and anxiolytics, including selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, and benzodiazepines. For each condition, the total disease population and the number of patients prescribed at least one psychotropic medication were quantified. Condition-specific prevalence of psychotropic medication use was calculated.

Results

Psychotropic medication use varied across disease populations. Prevalence ranged from 1.87% among patients with rheumatoid arthritis to 9.83% among patients with ulcerative colitis. Higher prevalence was observed among patients with asthma (7.23%), multiple sclerosis (6.06%), and systemic lupus erythematosus (5.58%). Moderate prevalence was identified in Crohn’s disease (3.77%), CVID (3.78%), and T1DM (3.36%). These findings demonstrate measurable psychotropic medication use among patients with chronic and immune-mediated diseases, with notable variation by condition.

Conclusions

Psychotropic medication use is common among patients with chronic and immune-mediated diseases, reflecting frequent co-occurrence of psychiatric treatment within these populations. These descriptive findings are hypothesis-generating and do not imply causality. Future analyses incorporating psychiatric diagnoses, demographic characteristics, and longitudinal data are needed to better characterize patterns of psychiatric comorbidity and psychotropic prescribing in medically complex patients.