Szigethy Eva, Craig Anna E, Iobst Emily A, Grand Richard J, Keljo David, DeMaso David, Noll Robert
Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Department of Psychiatry, Pittsburgh, PA 15213, USA. DeSoto Wing, Pittsburgh, PA 15213, USA.
Inflamm Bowel Dis. 2009 Jan;15(1):69-74. doi: 10.1002/ibd.20693.
The purpose was to determine the utility of including neurovegetative symptoms in assessments of depression in youth with inflammatory bowel disease (IBD).
Forty-one youth with IBD and concurrent depressive symptomatology were enrolled in an intervention trial and received either 9 modules of cognitive-behavioral therapy (PASCET-PI) or treatment as usual (TAU). Youth and their primary caregivers completed the Children's Depression Inventory (CDI) at pre- (T1) and posttreatment (T2). Disease severity measures and current steroid dosage were obtained at each timepoint. Change in the individual items of the CDI was compared across groups and examined in association with change in physical illness course.
Paired sample t-tests revealed significant changes in CDI item scores from T1 to T2 for a majority of the depressive symptoms assessed in the PASCET-PI group, but not for the TAU group. These changes did not appear to be linked to changes in disease severity and/or steroid dosage across these same timepoints.
The inclusion of somatic items in the assessment of depression in physically ill youth is important, as these symptoms seem to respond to psychotherapeutic intervention. The present results would suggest that improvements in depressive symptomatology are not solely related to improvements in the course of IBD and that these items do reflect an important part of the profile of depressive symptoms in youth with IBD. Future research is warranted to replicate present findings and explore the generalizability of these results to other pediatric illness populations.
目的是确定在评估炎症性肠病（IBD）青少年的抑郁症时纳入神经植物性症状的效用。
41名患有IBD且同时伴有抑郁症状的青少年参加了一项干预试验，他们接受了9个模块的认知行为疗法（PASCET-PI）或常规治疗（TAU）。青少年及其主要照顾者在治疗前（T1）和治疗后（T2）完成儿童抑郁量表（CDI）。在每个时间点获取疾病严重程度指标和当前类固醇剂量。比较两组间CDI各项目的变化，并与身体疾病进程的变化相关联进行检查。
配对样本t检验显示，PASCET-PI组评估的大多数抑郁症状从T1到T2的CDI项目得分有显著变化，而TAU组没有。这些变化似乎与同一时间点疾病严重程度和/或类固醇剂量的变化无关。
在评估身体患病青少年的抑郁症时纳入躯体项目很重要，因为这些症状似乎对心理治疗干预有反应。目前的结果表明，抑郁症状的改善并不完全与IBD病程的改善相关，并且这些项目确实反映了IBD青少年抑郁症状特征的重要部分。有必要进行未来研究以重复目前的发现，并探索这些结果对其他儿科疾病人群的普遍性。
