Anxiety and Depression Are Associated with Poor Long-term Quality of Life in Moderate-to-Severe Ulcerative Colitis: Results of a 3-Year Longitudinal Study of the MOSAIK Cohort.

IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Gut and Liver Pub Date : 2024-11-07 DOI:10.5009/gnl240146
Shin Ju Oh, Chang Hwan Choi, Sung-Ae Jung, Geun Am Song, Yoon Jae Kim, Ja Seol Koo, Sung Jae Shin, Geom Seog Seo, Kang-Moon Lee, Byung Ik Jang, Eun Suk Jung, Youngdoe Kim, Chang Kyun Lee
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引用次数: 0

Abstract

Background/aims: We previously reported that patients with moderate-to-severe ulcerative colitis (UC) often experience common mental disorders (CMDs) such as anxiety and depression, necessitating immediate psychological interventions within the first 4 weeks of diagnosis. In this 3-year follow-up study of the MOSAIK cohort in Korea, we examined the effects of CMDs at initial diagnosis on clinical outcomes and health-related quality of life (HRQoL).

Methods: We examined differences in clinical outcomes (evaluated based on clinical response, relapse, hospitalization, and medication use) and HRQoL (assessed using the Inflammatory Bowel Disease Questionnaire [IBDQ] and Short Form 12 [SF-12]) according to Hospital Anxiety and Depression Scale (HADS) scores at diagnosis.

Results: In a study involving 199 UC patients, 47.7% exhibited significant psychological distress (anxiety and/or depression) at diagnosis. Clinical follow-up showed no major differences in outcomes, including remission rates, response rates, or hospitalization rates, between patients with anxiety or depression at diagnosis and patients without anxiety or depression at diagnosis. The HRQoL at the end of follow-up was notably lower in those with baseline CMDs, particularly anxiety, across all domains of the IBDQ and SF-12. Linear mixed-effect models revealed that higher HADS scores, as well as higher Mayo scores, were independently associated with lower IBDQ scores and both summary domains of the SF-12. Additionally, regular attendance at follow-up visits during the study period was also related to improvements in HRQoL (all p<0.05).

Conclusions: While CMDs present at the time of UC diagnosis did not influence long-term clinical outcomes, they persistently impaired HRQoL. Our findings support the routine incorporation of psychological interventions into the long-term management of moderate-to-severe UC.

焦虑和抑郁与中重度溃疡性结肠炎患者长期生活质量低下有关:MOSAIK队列3年纵向研究结果。
背景/目的:我们以前曾报道过,中重度溃疡性结肠炎(UC)患者通常会出现焦虑和抑郁等常见精神障碍(CMDs),因此需要在确诊后的最初 4 周内立即进行心理干预。在这项为期 3 年的韩国 MOSAIK 队列随访研究中,我们考察了初次诊断时的 CMD 对临床结果和健康相关生活质量(HRQoL)的影响:我们根据诊断时的医院焦虑和抑郁量表(HADS)评分,研究了临床结果(根据临床反应、复发、住院和用药情况进行评估)和 HRQoL(使用炎症性肠病问卷 [IBDQ] 和简表 12 [SF-12]进行评估)的差异:在一项涉及199名UC患者的研究中,47.7%的患者在确诊时表现出明显的心理困扰(焦虑和/或抑郁)。临床随访结果显示,诊断时患有焦虑症或抑郁症的患者与诊断时不患有焦虑症或抑郁症的患者在治疗效果(包括缓解率、反应率或住院率)方面没有重大差异。在 IBDQ 和 SF-12 的所有领域中,基线 CMD(尤其是焦虑)患者随访结束时的 HRQoL 明显较低。线性混合效应模型显示,较高的 HADS 得分和较高的 Mayo 得分与较低的 IBDQ 得分和 SF-12 的两个摘要领域都有独立关联。此外,在研究期间定期参加随访也与 HRQoL 的改善有关(所有 p 结论:虽然 UC 诊断时存在的 CMD 不会影响长期临床结果,但它们会持续损害 HRQoL。我们的研究结果支持将心理干预纳入中重度 UC 的长期管理中。
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来源期刊
Gut and Liver
Gut and Liver 医学-胃肠肝病学
CiteScore
7.50
自引率
8.80%
发文量
119
审稿时长
6-12 weeks
期刊介绍: Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.
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