Depressive and anxiety symptoms among patients with inflammatory bowel diseases
Abstract
Introduction. This study was conducted on a population of patients with inflammatory bowel disease (IBD) and was based on an assessment of the prevalence and severity of depression and anxiety symptoms in various clinical aspects. The psychological features of IBD patients are very important in the perception of symptoms, but crucial as triggers of IBD or as a releasing factor for IBD symptoms recurrence.
Methods. The study included 130 patients with IBD, including 68 with Crohn’s disease (CD) and 62 with ulcerative colitis (UC). The severity of anxiety and depression symptoms were examined by the Hospital Anxiety and Depression Scale (HADS). Patients were also subjected to assessment of anthropometric attributes, clinical factors, quality of life, and symptoms of the disease, with dedicated clinical scales.
Results. The occurrence of significant symptoms of anxiety was estimated at 45.5% in patients with CD and 30.5% in the UC patients. Significant depressive symptoms related to 20.5% of people with CD and 17.5% of patients with UC. The parameters of anxiety and depression showed significant associations with parameters of quality of life, BMI, and the scales describing the exacerbation of the diseases.
Conclusions. The analyses did not reveal significant differences in the severity and prevalence of symptoms of anxiety and depression in subgroups with IBD. The expansion of relevant symptoms of anxiety and depression in this population was greater than in the general population. In addition, there was a significant correlation between parameters of HADS and clinical factors.
Keywords: depressionanxietyinflammatory bowel diseaseCrohn’s diseaseulcerative colitis
References
- Lucendo AJ, Hervías D, Roncero Ó, et al. Epidemiology and temporal trends (2000-2012) of inflammatory bowel disease in adult patients in a central region of Spain. Eur J Gastroenterol Hepatol. 2014; 26(12): 1399–1407.
- Elson CO, Cong Y, McCracken VJ, et al. Experimental models of inflammatory bowel disease reveal innate, adaptive, and regulatory mechanisms of host dialogue with the microbiota. Immunol Rev. 2005; 206: 260–276.
- Zhang YZ, Li YY. Inflammatory bowel disease: pathogenesis. World J Gastroenterol. 2014; 20(1): 91–99.
- Zhiqin W, Palaniappan S, Raja Ali RA. Inflammatory Bowel Disease-related Colorectal Cancer in the Asia-Pacific Region: Past, Present, and Future. Intest Res. 2014; 12(3): 194–204.
- Lix LM, Graff LA, Walker JR, et al. Longitudinal study of quality of life and psychological functioning for active, fluctuating, and inactive disease patterns in inflammatory bowel disease. Inflamm Bowel Dis. 2008; 14(11): 1575–1584.
- Byeon YuMi, Lee J, Lee SJ, et al. Peritonsillar Involvement in Pyoderma Gangrenosum associated with Ulcerative Colitis. Intest Res. 2014; 12(2): 153–156.
- Kim MC, Jung YS, Song YS, et al. Factors Associated with Anxiety and Depression in Korean Patients with Inactive Inflammatory Bowel Disease. Gut Liver. 2016; 10(3): 399–405.
- Laass M, Roggenbuck D, Conrad K. Diagnosis and classification of Crohn's disease. Autoimmunity Reviews. 2014; 13(4-5): 467–471.
- Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012; 142(1): 46–54.e42; quiz e30.
- Stepaniuk P, Bernstein CN, Targownik LE, et al. Characterization of inflammatory bowel disease in elderly patients: A review of epidemiology, current practices and outcomes of current management strategies. Can J Gastroenterol Hepatol. 2015; 29(6): 327–333.
- Conrad K, Roggenbuck D, Laass MW. Diagnosis and classification of ulcerative colitis. Autoimmun Rev. 2014; 13(4-5): 463–466.
- Rusu F, Dumitraşcu DL. Four years Follow-up of Patients with Irritable Bowel Syndrome. Rom J Intern Med. 2015; 53(1): 63–72.
- Häuser W, Janke KH, Klump B, et al. Anxiety and depression in patients with inflammatory bowel disease: comparisons with chronic liver disease patients and the general population. Inflamm Bowel Dis. 2011; 17(2): 621–632.
- Panara AJ, Yarur AJ, Rieders B, et al. The incidence and risk factors for developing depression after being diagnosed with inflammatory bowel disease: a cohort study. Aliment Pharmacol Ther. 2014; 39(8): 802–810.
- Long MD, Kappelman MD, Martin CF, et al. Risk factors for depression in the elderly inflammatory bowel disease population. J Crohns Colitis. 2014; 8(2): 113–119.
- Goodhand JR, Wahed M, Mawdsley JE, et al. Mood disorders in inflammatory bowel disease: relation to diagnosis, disease activity, perceived stress, and other factors. Inflamm Bowel Dis. 2012; 18(12): 2301–2309.
- Ananthakrishnan AN, Khalili H, Pan An, et al. Association between depressive symptoms and incidence of Crohn's disease and ulcerative colitis: results from the Nurses' Health Study. Clin Gastroenterol Hepatol. 2013; 11(1): 57–62.
- Fuller-Thomson E, Lateef R, Sulman J. Robust Association Between Inflammatory Bowel Disease and Generalized Anxiety Disorder: Findings from a Nationally Representative Canadian Study. Inflamm Bowel Dis. 2015; 21(10): 2341–2348.
- Häuser W, Janke KH, Klump B, et al. Anxiety and depression in patients with inflammatory bowel disease: comparisons with chronic liver disease patients and the general population. Inflamm Bowel Dis. 2011; 17(2): 621–632.
- Sajadinejad MS, Asgari K, Molavi H, et al. Psychological issues in inflammatory bowel disease: an overview. Gastroenterol Res Pract. 2012; 2012: 106502.
- Addolorato G, Capristo E, Stefanini GF, et al. Inflammatory bowel disease: a study of the association between anxiety and depression, physical morbidity, and nutritional status. Scand J Gastroenterol. 1997; 32(10): 1013–1021.
- Mittermaier C, Dejaco C, Waldhoer T, et al. Impact of depressive mood on relapse in patients with inflammatory bowel disease: a prospective 18-month follow-up study. Psychosom Med. 2004; 66(1): 79–84.
- Andrews H, Barczak P, Allan RN. Psychiatric illness in patients with inflammatory bowel disease. Gut. 1987; 28(12): 1600–1604.
- Ross SC, Strachan J, Russell RK, et al. Psychosocial functioning and health-related quality of life in paediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2011; 53(5): 480–488.
- Brooks AJ, Rowse G, Ryder A, et al. Systematic review: psychological morbidity in young people with inflammatory bowel disease - risk factors and impacts. Aliment Pharmacol Ther. 2016; 44(1): 3–15.
- Pierce GL, Kalil GZ, Ajibewa T, et al. Anxiety independently contributes to elevated inflammation in humans with obesity. Obesity (Silver Spring). 2017; 25(2): 286–289.
- Ma J, Xiao L. Obesity and depression in US women: results from the 2005-2006 National Health and Nutritional Examination Survey. Obesity (Silver Spring). 2010; 18(2): 347–353.
- Gadalla TM. Association of obesity with mood and anxiety disorders in the adult general population. Chronic Dis Can. 2009; 30(1): 29–36.
- Singh S, Dulai PS, Zarrinpar A, et al. Obesity in IBD: epidemiology, pathogenesis, disease course and treatment outcomes. Nat Rev Gastroenterol Hepatol. 2017; 14(2): 110–121.
- Harper JW, Zisman TL. Interaction of obesity and inflammatory bowel disease. World J Gastroenterol. 2016; 22(35): 7868–7881.
- Nordin K, Påhlman L, Larsson K, et al. Health-related quality of life and psychological distress in a population-based sample of Swedish patients with inflammatory bowel disease. Scand J Gastroenterol. 2002; 37(4): 450–457.
- Kalafateli M, Triantos C, Theocharis G, et al. Health-related quality of life in patients with inflammatory bowel disease: a single-center experience. Ann Gastroenterol. 2013; 26(3): 243–248.