Li Jing, Ng Wing-Yi, Qiao Li-Chao, Yuan Fen, Lan Xing, Zhu Li-Bei, Yang Bo-Lin, Wang Zhong-Qiu
Department of Radiology, Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Department of Acupuncture and Rehabilitation, Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
World J Psychiatry. 2024 May 19;14(5):715-725. doi: 10.5498/wjp.v14.i5.715.
Psychological distress, especially depression, associated with perianal fistulizing Crohn's disease (PFCD) is widespread and refractory. However, there is a surprising paucity of studies to date that have sought to identify the prevalence and risk factors of depression associated with PFCD.
To estimate the prevalence of depressive symptoms and investigate the depression-related risk factors in patients with PFCD.
The study was conducted in the form of survey and clinical data collection questionnaire and specialized medical staff. Depressive symptoms, life quality, and fatigue severity of patients with PFCD were assessed by Patient Health Questionnaire-9, Inflammatory Bowel Disease Patient Quality of Life Questionnaire (IBDQ), and Inflammatory Bowel Disease (IBD) Fatigue Patient Self-assessment Scale. The basic demographic information, overall disease features, perianal clinical information, and laboratory inflammation indicators were also gathered. Multivariate regression analysis was ultimately used to ascertain the risk factors of depression associated with PFCD.
A total of 123 patients with PFCD were involved, and 56.91% were suffering from depression. According to multivariate logistic regression analysis, Perianal Disease Activity Index (PDAI) score [odds ratio (OR) = 0.69, 95% confidence interval (CI): 0.50 to 0.95], IBDQ score (OR = 0.93, 95%CI: 0.88 to 0.97), modified Van Assche index (OR = 1.24, 95%CI: 1.01 to 1.53), and IBD Fatigue score (OR = 1.72, 95%CI: 1.23 to 2.42) were independent risk factors of depression-related prevalence among patients with PFCD ( < 0.05). Multiple linear regression analysis revealed that the increasing perianal modified Van Assche index ( value = 0.166, 95%CI: 0.02 to 0.31) and decreasing IBDQ score ( value = -0.116, 95%CI: -0.14 to -0.09) were independently associated with the severity of depression ( < 0.05).
Depressive symptoms in PFCD patients have significantly high prevalence. PDAI score, modified Van Assche index, quality of life, and fatigue severity were the main independent risk factors.
与肛周瘘管性克罗恩病（PFCD）相关的心理困扰，尤其是抑郁症，普遍存在且难以治疗。然而，迄今为止，旨在确定与PFCD相关的抑郁症患病率和危险因素的研究却出奇地少。
评估PFCD患者抑郁症状的患病率，并调查与抑郁症相关的危险因素。
本研究以问卷调查和临床数据收集的形式进行，由专业医务人员参与。通过患者健康问卷-9、炎症性肠病患者生活质量问卷（IBDQ）和炎症性肠病（IBD）疲劳患者自评量表评估PFCD患者的抑郁症状、生活质量和疲劳严重程度。同时收集基本人口统计学信息、整体疾病特征、肛周临床信息和实验室炎症指标。最终采用多因素回归分析确定与PFCD相关的抑郁症危险因素。
共纳入123例PFCD患者，其中56.91%患有抑郁症。根据多因素logistic回归分析，肛周疾病活动指数（PDAI）评分[比值比（OR）=0.69，95%置信区间（CI）：0.50至0.95]、IBDQ评分（OR = 0.93，95%CI：0.88至0.97）、改良Van Assche指数（OR = 1.24，95%CI：1.01至1.53）和IBD疲劳评分（OR = 1.72，95%CI：1.23至2.42）是PFCD患者抑郁症相关患病率的独立危险因素（P<0.05）。多元线性回归分析显示，肛周改良Van Assche指数升高（β值=0.166，95%CI：0.02至0.31）和IBDQ评分降低（β值=-0.116，95%CI：-0.14至-0.09）与抑郁症严重程度独立相关（P<0.05）。
PFCD患者抑郁症状的患病率显著较高。PDAI评分、改良Van Assche指数、生活质量和疲劳严重程度是主要的独立危险因素。
