Sheffield Teaching Hospitals NHS Foundation Trust, Academic Department of Gastroenterology, Sheffield, UK.
Department of Psychology, University of Sheffield, Sheffield, UK.
J Crohns Colitis. 2019 Aug 14;13(8):1003-1011. doi: 10.1093/ecco-jcc/jjz028.
Psychological morbidity is increased in young people with inflammatory bowel disease [IBD]. Illness perceptions may be an important factor. This study aimed to describe the prevalence and severity of psychological morbidity and to examine relationships between baseline illness perceptions and anxiety, depression, and health-related quality of life [HRQoL], at baseline and 12 months later, in 16-21 year olds with IBD.
IBD patients [n = 121] completed measures of anxiety, depression, HRQoL, and illness perceptions [IPQ-R] at baseline and follow-up [n = 100, 83%].
Among the 121 patients at baseline [median age 19.3 years, 40% female, 62% Crohn's disease, 73% in clinical remission], 55% reported elevated symptoms of anxiety/depression and 83% reported low HRQoL. Negative illness perceptions at baseline were significantly correlated with greater anxiety, depression, and lower HRQoL at baseline and follow-up. In regression analysis at baseline, the IPQ-R domain of greater perception of a cyclical nature of IBD was an independent predictor of anxiety, and a greater perceived emotional impact of IBD was an independent predictor of anxiety, depression, and HRQoL. Female gender and clinical relapse were also independent predictors of lower HRQoL. After controlling for baseline measures, clinical risk factors and illness perceptions did not explain additional variance in psychological morbidity at follow-up.
A high prevalence of psychological morbidity, stable over 1 year, was demonstrated in young people with IBD. Having negative illness perceptions, being female, and having active disease predicted those at greatest risk of psychological morbidity. Illness perceptions may be an appropriate target for psychological interventions.
炎症性肠病（IBD）患者的年轻人中，心理发病率升高。疾病认知可能是一个重要因素。本研究旨在描述青少年 IBD 患者心理发病率的流行率和严重程度，并探讨基线疾病认知与焦虑、抑郁和健康相关生活质量（HRQoL）之间的关系，包括基线和 12 个月后的情况。
IBD 患者（n = 121）在基线和随访时完成焦虑、抑郁、HRQoL 和疾病认知（IPQ-R）的评估[n = 100，83%完成随访]。
在基线的 121 例患者中（中位年龄 19.3 岁，40%为女性，62%为克罗恩病，73%处于临床缓解期），55%报告存在焦虑/抑郁的症状升高，83%报告 HRQoL 较低。基线时负面的疾病认知与基线和随访时更大的焦虑、抑郁和更低的 HRQoL 显著相关。在基线的回归分析中，IBD 周期性认知维度更大是焦虑的独立预测因素，而对 IBD 情绪影响的感知更大是焦虑、抑郁和 HRQoL 的独立预测因素。女性和临床复发也是 HRQoL 降低的独立预测因素。在控制基线测量后，临床危险因素和疾病认知并不能解释随访时心理发病率的额外变化。
在青少年 IBD 患者中，心理发病率高，且在 1 年内保持稳定。具有负面疾病认知、女性和活动性疾病的患者具有更大的心理发病率风险。疾病认知可能是心理干预的适当目标。
