Walter Jennifer G, Kahn Stacy A, Noe Joshua D, Schurman Jennifer V, Miller Steven A, Greenley Rachel N
*Department of Pediatrics, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois; †Department of Pediatrics, University of Chicago; ‡Department of Pediatrics, Medical College of Wisconsin; and §Department of Developmental and Behavioral Pediatrics, Children's Mercy Hospitals and Clinics.
Inflamm Bowel Dis. 2016 Feb;22(2):402-8. doi: 10.1097/MIB.0000000000000657.
Previous research is discrepant with respect to the prevalence of internalizing symptoms (i.e., depressive and anxiety symptoms) in pediatric inflammatory bowel disease (IBD) samples. Moreover, few studies have examined the combined influence of demographic and disease-related risk factors for internalizing symptoms. This study described rates of depressive, anxiety, and overall internalizing symptomatology in a multisite sample of youth with established IBD diagnoses. Additionally, the study examined risk factors for elevated depressive, anxiety, and internalizing symptoms, including those in demographic (i.e., family income and sex) and disease (i.e., disease activity and functional disability) domains.
One hundred sixty-one youth (aged 11-18 yr) with established IBD diagnoses, primarily inactive disease, prescribed oral medications, and who were not taking corticosteroids were recruited from outpatient Gastroenterology Clinics at 3 children's hospitals. This article reflects a secondary analysis of data collected from 2 larger studies examining oral medication adherence and psychosocial functioning in pediatric IBD. After providing written consent/assent, participants completed questionnaires assessing demographics, functional disability, and internalizing symptoms. Medical records were reviewed for disease information and clinical disease activity ratings.
Only 13% of the sample reported clinically elevated anxiety or depressive symptoms. Perceived functional disability, but not clinical disease activity, was associated with higher depressive and anxiety symptoms, and higher overall internalizing symptomatology.
Current results highlight the need to look beyond disease severity and examine the perception of functional disability of patients with IBD when seeking to identify youth at risk for internalizing symptoms such as depression and anxiety.
先前的研究在小儿炎症性肠病(IBD)样本中内化症状(即抑郁和焦虑症状)的患病率方面存在差异。此外,很少有研究考察人口统计学和疾病相关风险因素对内化症状的综合影响。本研究描述了已确诊IBD的多地点青少年样本中抑郁、焦虑和总体内化症状的发生率。此外,该研究还考察了抑郁、焦虑和内化症状升高的风险因素,包括人口统计学(即家庭收入和性别)和疾病(即疾病活动度和功能残疾)方面的因素。
从3家儿童医院的门诊胃肠病诊所招募了161名已确诊IBD的青少年(年龄11 - 18岁),主要为非活动性疾病,正在服用口服药物,且未服用皮质类固醇。本文反映了对从2项更大规模研究中收集的数据进行的二次分析,这2项研究考察了小儿IBD患者的口服药物依从性和心理社会功能。在获得书面同意/赞成后,参与者完成了评估人口统计学、功能残疾和内化症状的问卷。查阅病历以获取疾病信息和临床疾病活动度评分。
只有13%的样本报告临床焦虑或抑郁症状升高。感知到的功能残疾而非临床疾病活动度与更高的抑郁和焦虑症状以及更高的总体内化症状相关。
当前结果凸显了在试图识别有抑郁和焦虑等内化症状风险的青少年时,需要超越疾病严重程度,考察IBD患者对功能残疾的感知。