临床疾病活动与青少年和年轻成年人炎症性肠病的焦虑和抑郁症状相关。

Clinical disease activity is associated with anxiety and depressive symptoms in adolescents and young adults with inflammatory bowel disease.

机构信息

Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.

Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.

出版信息

Aliment Pharmacol Ther. 2018 Aug;48(3):358-369. doi: 10.1111/apt.14832. Epub 2018 Jun 13.

DOI:10.1111/apt.14832

PMID:29897134

Abstract

BACKGROUND

Youths with inflammatory bowel disease (IBD) are at risk for developing anxiety and depressive symptoms with a reported 20%-50% prevalence rate.

AIMS

This prospective study aimed to: (1) describe the prevalence and severity of anxiety and depressive symptoms in a large Dutch cohort of young IBD patients, and (2) identify demographic and clinical risk factors for anxiety and depression.

METHODS

IBD patients (n = 374; 10-25 years) were screened for anxiety, depression and quality of life using validated age-specific questionnaires. Patients with elevated scores for anxiety and/or depressive symptoms received a diagnostic interview assessing psychiatric disorders. Demographic and clinical characteristics were retrieved from medical charts. Multiple logistic regression analysis was performed to identify risk factors for anxiety and/or depression.

RESULTS

Patients (mean age 18.9 years, 44.1% male, Crohn's disease 60.4%) had disease in remission (75.4%), or mild, moderate and severe clinical disease activity in, respectively, 19.8%, 2.7% and 2.1%. Mild anxiety/depressive symptoms were present in 35.2% and severe symptoms in 12.4% of patients. Elevated symptoms of either anxiety (28.3%), depression (2.9%) or both (15.8%) were found and did not differ between adolescents (10-17 years) and young adults (18-25 years). Active disease significantly predicted depressive symptoms (odds ratio (OR): 4.6 [95% confidence interval [CI]: 2.4-8.8], P < 0.001). Female gender (OR: 1.7 [95% CI: 1.1-2.7]), active disease (OR: 1.9 [95% CI: 1.1-3.2]) and a shorter disease duration (OR: 1.3 [95% CI: 0.6-1.0) (all P < 0.025) significantly predicted anxiety and/or depressive symptoms.

CONCLUSIONS

Considering the high prevalence of anxiety and depressive symptoms, psychological screening is recommended in young IBD patients. Screening facilitates early recognition and psychological treatment. Female patients and patients with active disease are the most vulnerable.

摘要

背景

炎症性肠病（IBD）患者发生焦虑和抑郁症状的风险较高，其报告发病率为 20%-50%。

目的

本前瞻性研究旨在：（1）描述荷兰大型青年 IBD 患者队列中焦虑和抑郁症状的流行率和严重程度；（2）确定焦虑和抑郁的人口统计学和临床危险因素。

方法

使用特定年龄的验证问卷对 IBD 患者（n=374；10-25 岁）进行焦虑、抑郁和生活质量筛查。对焦虑和/或抑郁评分升高的患者进行评估精神障碍的诊断性访谈。从病历中获取人口统计学和临床特征。采用多元逻辑回归分析确定焦虑和/或抑郁的危险因素。

结果

患者（平均年龄 18.9 岁，44.1%为男性，克罗恩病 60.4%）疾病处于缓解期（75.4%），或轻度、中度和重度临床疾病活动度，分别占 19.8%、2.7%和 2.1%。35.2%的患者存在轻度焦虑/抑郁症状，12.4%的患者存在严重症状。发现焦虑（28.3%）、抑郁（2.9%）或两者均升高（15.8%）的症状，青少年（10-17 岁）和年轻成年人（18-25 岁）之间没有差异。活动期疾病显著预测抑郁症状（比值比[OR]：4.6[95%置信区间[CI]：2.4-8.8]，P<0.001）。女性（OR：1.7[95%CI：1.1-2.7]）、活动期疾病（OR：1.9[95%CI：1.1-3.2]）和较短的疾病病程（OR：1.3[95%CI：0.6-1.0]）（均 P<0.025）显著预测焦虑和/或抑郁症状。