The relationships between depression, inflammation and self-reported disease activity in IBD and their impact on healthcare usage.

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Natasha Seaton, Vari Wileman, Christine Norton, Joanna Hudson, Valeria Mondelli, Rona Moss-Morris
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引用次数: 0

Abstract

Background: Depression is common in people living with Inflammatory Bowel Disease (IBD). Depression rates increase with active disease and are linked to poorer clinical outcomes. Previous studies investigating the relationship between contemporaneous IBD disease activity and depression are often poorly controlled, use small samples and/or rely on self-reported measures of disease activity. Depression and self-reported disease activity (SRDA) are linked to increased healthcare usage, however, objective inflammation is rarely statistically controlled. The primary aim was to understand how self-reported disease activity and inflammation are related to depression. Secondary aims included assessing the relative influence of self-reported disease activity, inflammation and depression on healthcare usage.

Methods: This was a cross-sectional analysis of baseline data collected as part of a randomised controlled trial (trial registration no: ISRCTN71618461) of a digital treatment for symptom self-management in IBD (n = 599). Bivariate associations of demographic and clinical variables with depression were conducted to identify relevant covariates. Multiple linear regressions assessed (i) the relationships between depression (Patient Health Questionnaire-9 (PHQ-9)), SRDA (IBD-Control) and intestinal inflammation (faecal calprotectin (FCP)) and (ii) whether these variables explained variance in healthcare usage and economic indicators.

Results: Depression was significantly predicted by SRDA (β = -0.82, p < 0.001) but not FCP, with the model explaining 37% of the variance in depression (F(2,596) = 175.1, p < 0.001). FCP was only weakly associated with SRDA (r = -0.16, p < 0.001). Depression was independently associated with visits to primary care (β = 0.19, p < 0.001), IBD secondary care (β = 0.13, p < 0.001), IBD-related A&E attendance (β = 0.10 p < 0.05) and the impact of IBD on productivity (β = 0.24 p < 0.001) in the last 3 months.

Conclusions: Depression was related to SRDA but not FCP. Depression was also associated with healthcare usage even when SRDA and inflammation were statistically controlled. Routinely assessing and treating depression in IBD alongside managing inflammation may improve symptoms for patients and reduce healthcare costs.

IBD患者抑郁、炎症和自我报告疾病活动之间的关系及其对医疗保健使用的影响
背景:抑郁症在炎症性肠病(IBD)患者中很常见。抑郁症发病率随着活动性疾病的增加而增加,并且与较差的临床结果有关。先前调查同期IBD疾病活动与抑郁之间关系的研究通常控制不佳,使用小样本和/或依赖于疾病活动的自我报告测量。抑郁和自我报告的疾病活动(SRDA)与医疗保健使用的增加有关,然而,客观炎症很少在统计上得到控制。研究的主要目的是了解自我报告的疾病活动和炎症与抑郁症之间的关系。次要目的包括评估自我报告的疾病活动、炎症和抑郁对医疗保健使用的相对影响。方法:这是一项随机对照试验(试验注册号:ISRCTN71618461)收集的基线数据的横断面分析,该试验是IBD症状自我管理的数字治疗(n = 599)的一部分。通过人口统计学和临床变量与抑郁症的双变量关联来确定相关协变量。多元线性回归评估了(i)抑郁(患者健康问卷-9 (PHQ-9))、SRDA (IBD-Control)和肠道炎症(粪钙保护蛋白(FCP))之间的关系,以及(ii)这些变量是否解释了医疗保健使用和经济指标的差异。结果:SRDA对抑郁有显著预测作用(β = -0.82, p)。结论:抑郁与SRDA相关,与FCP无关。即使SRDA和炎症在统计上得到控制,抑郁也与医疗保健使用有关。常规评估和治疗IBD患者的抑郁以及控制炎症可能会改善患者的症状并降低医疗成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Gastroenterology
BMC Gastroenterology 医学-胃肠肝病学
CiteScore
4.20
自引率
0.00%
发文量
465
审稿时长
6 months
期刊介绍: BMC Gastroenterology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of gastrointestinal and hepatobiliary disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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