Reed-Knight Bonney, Lobato Debra, Hagin Sarah, McQuaid Elizabeth L, Seifer Ronald, Kopel Sheryl J, Boergers Julie, Nassau Jack H, Suorsa Kristina, Bancroft Barbara, Shapiro Jason, Leleiko Neal S
*Division of Child and Adolescent Psychiatry, Department of Psychiatry, Hasbro Children's Hospital/The Rhode Island Hospital, Providence, Rhode Island; †Warren Alpert Medical School of Brown University, Providence, Rhode Island; ‡Bradley Hasbro Children's Research Center, Providence, Rhode Island; and §Division of Pediatric Gastroenterology, Nutrition and Liver Diseases, Department of Pediatrics, Hasbro Children's Hospital/The Rhode Island Hospital, Providence, Rhode Island.
Inflamm Bowel Dis. 2014 Apr;20(4):614-21. doi: 10.1097/01.MIB.0000442678.62674.b7.
Previous investigations have produced mixed findings on whether youth with inflammatory bowel disease (IBD) experience elevated rates of depressive symptoms. Our first aim was to compare self-report of depressive symptoms by youth with IBD with a community sample. The second aim was to examine the relationship between symptoms of depression and measures of disease activity.
Item-level responses on the Children's Depression Inventory among a sample of 78 youth diagnosed with IBD were compared with responses from a community sample using 1-sample t-tests. Particular attention was given to items assessing somatic symptoms of depression given the potential overlap with IBD disease symptoms. The relationship between depressive symptoms and IBD disease activity was evaluated using Spearman's rank correlation coefficients and linear regression.
Youth with IBD reported lower levels of depressive symptoms compared with the community sample on the Children's Depression Inventory Total Score, and similar or lower levels of difficulty on items assessing somatic symptoms. Most of the sample had inactive or mild disease activity at the time of participation, with 14% experiencing moderate/severe disease activity. Higher ratings of disease activity were related to greater depressive symptoms. Responses on somatic items from the Children's Depression Inventory were not differentially related to disease activity.
As a group, pediatric patients with IBD did not experience the clinical levels of depressive symptoms or elevations in depressive symptoms when compared with a community sample. Somatic symptoms of depression do not differentiate youth with IBD experiencing elevations in disease activity from youth experiencing nonsomatic symptoms of depression.
先前的调查对于炎症性肠病(IBD)青少年的抑郁症状发生率是否升高得出了不一致的结果。我们的首要目标是将IBD青少年的抑郁症状自我报告与社区样本进行比较。第二个目标是研究抑郁症状与疾病活动度指标之间的关系。
使用单样本t检验,将78名被诊断为IBD的青少年样本在儿童抑郁量表上的项目级反应与社区样本的反应进行比较。鉴于抑郁的躯体症状与IBD疾病症状可能存在重叠,因此特别关注评估这些症状的项目。使用Spearman等级相关系数和线性回归评估抑郁症状与IBD疾病活动度之间的关系。
在儿童抑郁量表总分上,与社区样本相比,IBD青少年报告的抑郁症状水平较低,在评估躯体症状的项目上难度水平相似或更低。大多数样本在参与研究时疾病活动不活跃或为轻度,14%的人经历中度/重度疾病活动。疾病活动度评分越高,抑郁症状越严重。儿童抑郁量表躯体项目的反应与疾病活动度无差异相关。
总体而言,与社区样本相比,IBD儿科患者未出现临床水平的抑郁症状或抑郁症状升高。抑郁的躯体症状并不能区分疾病活动度升高的IBD青少年与出现非躯体抑郁症状的青少年。