Depressive Symptoms and Inflammatory Bowel Disease in Children and Adolescents: A Cross-Sectional Study

Szigethy, Eva; Levy-Warren, Anna; Whitton, Sarah W.; Bousvaros, Athos; Gauvreau, Kimberlee; Leichtner, Alan M.; Beardslee, William R.

doi:10.1097/00005176-200410000-00017

Cited by 155 publications

(181 citation statements)

References 57 publications

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“…This finding suggests that the complex chronically ill children at freestanding children' s hospitals have a relatively high burden of mental health comorbidities, which is consistent with studies in chronically ill pediatric outpatients. [25][26][27][28][29] We also found that the most common comorbid mental health diagnoses differed between hospitals nationally and free-standing hospitals.…”

Section: Discussionmentioning

confidence: 57%

Common and Costly Hospitalizations for Pediatric Mental Health Disorders

et al. 2014

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BACKGROUND AND OBJECTIVES: Inpatient pediatric mental health is a priority topic for national quality measurement and improvement, but nationally representative data on the patients admitted or their diagnoses are lacking. Our objectives were: to describe pediatric mental health hospitalizations at general medical facilities admitting children nationally; to assess which pediatric mental health diagnoses are frequent and costly at these hospitals; and to examine whether the most frequent diagnoses are similar to those at free-standing children’s hospitals. METHODS: We examined all discharges in 2009 for patients aged 3 to 20 years in the nationally representative Kids’ Inpatient Database (KID) and in the Pediatric Health Information System (free-standing children’s hospitals). Main outcomes were frequency of International Classification of Diseases, Ninth Revision, Clinical Modification–defined mental health diagnostic groupings (primary and nonprimary diagnosis) and, using KID, resource utilization (defined by diagnostic grouping aggregate annual charges). RESULTS: Nearly 10% of pediatric hospitalizations nationally were for a primary mental health diagnosis, compared with 3% of hospitalizations at free-standing children’s hospitals. Predictors of hospitalizations for a primary mental health problem were older age, male gender, white race, and insurance type. Nationally, the most frequent and costly primary mental health diagnoses were depression (44.1% of all mental health admissions; $1.33 billion), bipolar disorder (18.1%; $702 million), and psychosis (12.1%; $540 million). CONCLUSIONS: We identified the child mental health inpatient diagnoses with the highest frequency and highest costs as depression, bipolar disorder, and psychosis, with substance abuse an important comorbid diagnosis. These diagnoses can be used as priority conditions for pediatric mental health inpatient quality measurement.

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Section: Discussionmentioning

confidence: 57%

Common and Costly Hospitalizations for Pediatric Mental Health Disorders

et al. 2014

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“…Both patients and staff reported acceptance of screening on qualitative surveys. Elevated CDI scores ($16) were found in 8% of the sample; moderate scores (10)(11)(12)(13)(14)(15) in 12% of the sample. Low risk scores were found in 80% of the sample.…”

Section: Resultsmentioning

confidence: 91%

“…Up to 9.5% of the general population of adolescents are depressed, [8][9][10] and the rate is 2 to 3 times higher for adolescents with type 1 diabetes and other chronic health conditions. [11][12][13][14][15][16] When present, depression in adolescents with type 1 diabetes is associated with less frequent blood glucose monitoring (BGM), 17 higher HbA1c values, [18][19][20][21] and increased rates of diabetes-related hospitalizations. 22,23 All of these negative health outcomes are associated with higher risk of longterm complications from diabetes and consequent increase in medical care costs.…”

Section: Resultsmentioning

confidence: 99%

Improving Depression Screening for Adolescents With Type 1 Diabetes

et al. 2013

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OBJECTIVE: Depression is common among adolescents, but rates increase significantly in the presence of chronic health conditions. Outpatient screening for depression is recommended but rarely formally conducted due to barriers of implementation. METHODS:To provide a model for depression screening of youth with chronic health conditions, a standard process using a selfadministered electronic version of the Children' s Depression Inventory (CDI) was developed. Quality improvement methodology and traditional analytic approaches were used to test the feasibility and outcomes of routine screening in patients 13 to 17 years of age with type 1 diabetes. RESULTS:Of the 528 eligible adolescents, 509 (96%) received at least 1 depression screen during the first year. The process was tested and refined in over 1200 patient encounters, which resulted in an increase in depression screening rates from ,5% to a median of 85% over the initial 12 months. Both patients and staff reported acceptance of screening on qualitative surveys. Elevated CDI scores ($16) were found in 8% of the sample; moderate scores (10-15) in 12% of the sample. Low risk scores were found in 80% of the sample. Higher CDI scores correlated with lower blood glucose monitoring frequency and higher hemoglobin A1c, confirming the link between more depression symptoms and poorer diabetes management and control. Suicidal ideation was endorsed in 7% of the population.CONCLUSIONS: Systematic depression screening in adolescents with type 1 diabetes can be reliably implemented with clinically significant results. A systematic approach, such as described in this study, can serve as a model for other chronic health conditions. Pediatrics

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“…It is well established that mental health disorders, particularly depression and anxiety, are prevalent comorbid conditions in adult as well as young patients with IBD ( 8,25,32,33 ). However, data on the incidences of anxiety disorders and depression specifi cally for young patients with CD are limited.…”

Section: Discussionmentioning

confidence: 99%

“…Szigethy et al ( 25 ) conducted a study of 102 patients aged 11 -17 years with IBD, and estimated that 24.5 % had clinically meaningful symptoms of depression. Further, patients with active IBD had signifi cantly more symptoms of depression than did patients who were in remission ( 25 ). Epidemiologic studies have indicated that an early onset of mental health disorders (e.g., anxiety and depression disorders) predicts poor long-term outcomes and chronic, recurrent mental health disorders in young adulthood and adulthood ( 26,27 ).…”

Section: Increased Risks Of Developing Anxiety and Depression In Younmentioning

confidence: 99%

Increased Risks of Developing Anxiety and Depression in Young Patients With Crohn's Disease

Loftus

Guérin

et al. 2011

American Journal of Gastroenterology

123

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OBJECTIVES:Crohn ' s disease (CD) is associated with substantial psychosocial burden and increased risks for mental health disorders. This retrospective cohort study compared the risks of developing anxiety disorders and depression and incidences of psychotropic medication use between young CD patients and matched CD-free controls. METHODS:Medical claims, prescription drug claims, enrollment, and demographic data for patients < 18 years diagnosed with CD were obtained from the MarketScan database (1 January 2000 -30 June 2006). Each CD patient was matched with fi ve CD-free controls based on exact age, sex, and months of health plan enrollment. Incidence rates and risks of developing anxiety disorders and depression and psychotropic medication use in the 6 months after the index date were compared, as were risks of developing persistent anxiety or depression (receiving medical services related to a diagnosis of anxiety or depression or psychotropic therapy for > 1 year). SUPPLEMENTARY MATERIAL is linked to the online version of the paper at RESULTS: After adjustment for patient characteristics, the risks of developing anxiety disorders (hazard ratio (HR) [95 % confi dence interval (CI

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Depressive Symptoms and Inflammatory Bowel Disease in Children and Adolescents: A Cross-Sectional Study

Abstract: These findings support the recommendation that adolescents with IBD in outpatient medical care settings, particularly older adolescents and those on steroids, should be screened for depression.

Cited by 155 publications

References 57 publications

Common and Costly Hospitalizations for Pediatric Mental Health Disorders

Common and Costly Hospitalizations for Pediatric Mental Health Disorders

Improving Depression Screening for Adolescents With Type 1 Diabetes

Increased Risks of Developing Anxiety and Depression in Young Patients With Crohn's Disease

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