Key result
While objective disease activity was not associated with psychological illness, gastrointestinal symptoms were strongly associated with severe depression (OR 20.78; 95% CI 6.71-92.37; P<0.001).
Why the study?
Disease activity may be a risk factor for psychological illness in patients with inflammatory bowel disease, but the correlation between objective measures of disease activity and psychological symptoms needed evaluation.
Observational (n=172)
Odds Ratio: 20.78 (95% CI 6.71–92.37)
p-value: p=<0.001
In patients with IBD, psychological symptoms are driven by gastrointestinal symptoms rather than objective measures of disease activity.
Objective IBD activity correlates weakly with psychological symptoms; leaves open whether inflammation drives mental health burden in prospective cohorts.
BACKGROUND: Disease activity may be a risk factor for psychological illness in patients with inflammatory bowel disease (IBD). AIM: To correlate objective measures of disease activity with psychological symptoms. METHODS: Adult patients with IBD undergoing ileocolonoscopy were prospectively recruited. Demographic, psychological symptoms (depression, anxiety, stress), disease activity (symptoms, biomarkers, endoscopy), and quality of life (QoL) data were collected. One-way ANOVA and multivariable analyses examined the associations between disease activity and symptoms of psychological illness, and identified other predictors of mental illness and reduced QoL. RESULTS: A total of 172 patients were included, 107 with Crohn's disease (CD) and 65 with ulcerative colitis (UC). There was no significant association between objective disease activity (endoscopic scores, faecal calprotectin or C-reactive protein) and depression, anxiety or stress scores (P > 0.05 for all comparisons). Gastrointestinal symptoms were significantly associated with symptoms of depression, anxiety and stress in patients with CD and UC (P < 0.05). On multivariable analysis, only gastrointestinal symptoms were associated with severe symptoms of depression (OR 20.78 [6.71-92.37], P < 0.001) and anxiety (OR 4.26 [1.70-12.25], P = 0.004). Anti-TNF and corticosteroid use, the presence of severe depressive, moderate-severe stress and gastrointestinal symptoms, and endoscopically active IBD were associated with a reduced QoL (P < 0.05). Longer duration of IBD predicted an improved QoL (P < 0.05). CONCLUSIONS: Objective measures of disease activity are not associated with symptoms of psychological illness in patients with IBD. Clinicians should consider underlying mental illness in patients with IBD with active gastrointestinal symptoms.
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Mules et al. (2021) conducted an observational in Inflammatory bowel disease (n=172). Gastrointestinal symptoms and objective disease activity was evaluated on Severe symptoms of depression (OR 20.78, 95% CI 6.71-92.37, p=<0.001). While objective disease activity was not associated with psychological illness, gastrointestinal symptoms were strongly associated with severe depression (OR 20.78; 95% CI 6.71-92.37; P<0.001).
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