Longitudinal study of quality of life and psychological functioning for active, fluctuating, and inactive disease patterns in inflammatory bowel disease

Lix, Lisa M.; Graff, Lesley A; Walker, John R.; Clara, Ian; Rawsthorne, Patricia; Rogala, Linda; Miller, Norine; Ediger, Jason; Pretorius, Thea; Bernstein, Çharles N.

doi:10.1002/ibd.20511

Cited by 217 publications

(144 citation statements)

References 41 publications

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“…In previous research, using a community-based IBD sample and a broad assessment of psychological functioning, our team found that those with active IBD managed more poorly in multiple domains, experiencing higher levels of distress, health anxiety, and perceived stress, and lower psychological wellbeing and mastery, relative to those with inactive disease, both crosssectionally and across a two-year period 25,26 . Once disease activity was accounted for, there were no differences in these aspects of functioning between those with ulcerative colitis (UC) and CD.…”

Section: Introductionmentioning

confidence: 90%

Stress Coping, Distress, and Health Perceptions in Inflammatory Bowel Disease and Community Controls

Graff

Walker

Clara

et al. 2009

American Journal of Gastroenterology

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108

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Psychological health and IBD 2Background: This study compares a community IBD sample with a matched non-IBD community sample on psychological functioning and health perceptions. Methods:Participants in the population-based Manitoba IBD Cohort Study (n=388) were directly compared with sex, age, and region-matched controls from a national random-sample health survey on aspects of psychological health, coping, and perceived general health. Results:The IBD sample overall had lower psychological wellbeing and mastery, and higher distress than the non-IBD controls (p < 0.02). Those with IBD used avoidant coping significantly more often, and active coping modestly more often than the non-IBD sample; both had similar levels of 'self-soothing' behaviors. Crohn's disease and ulcerative colitis participants had similarly poor levels of functioning along these dimensions compared to the non-IBD sample, as did those with active disease (p < 0.01). However, those with inactive disease were similar to the non-IBD sample, and had modestly higher mastery levels. While nearly half of the non-IBD group reported chronic health conditions, those with IBD were threefold more likely to report poorer health (OR 3.07, 95% CI 2.10-4.47). Psychological factors explained a greater amount of variance in perceived health for the IBD than the non-IBD sample. Conclusions:Those with IBD have significantly poorer psychological health than those without IBD and view their general health status more negatively, although adaptive stress coping strategies were similar. However, when disease is quiescent there is little detriment to functioning. Active disease should be a flag to consider psychological needs in the care of the IBD patient.Psychological health and IBD 3

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Section: Introductionmentioning

confidence: 90%

Stress Coping, Distress, and Health Perceptions in Inflammatory Bowel Disease and Community Controls

Graff

Walker

Clara

et al. 2009

American Journal of Gastroenterology

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108

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“…In fact, it has been found that depressed mood may stimulate the production of proinflammatory cytokines [16,17], modulating the clinical expression of IBD [6]. What is more, since increased IBD activity can influence the intensity of depression and anxiety experienced by patients [18][19][20], these mechanisms seem to unfold into a self-perpetuating cycle of psychological suffering and inflammation. It has thus 6 been pointed out that more priority to this subject should be given, and that more efforts should be made to uncover the mechanisms associated with the known effect of IBD symptomatology on depression [21].…”

Section: Inflammatory Bowel Disease and Psychological Distressmentioning

confidence: 99%

An 18-month study of the effects of IBD symptomatology and emotion regulation on depressed mood

Trindade

Ferreira

Moura‐Ramos

et al. 2017

Int J Colorectal Dis

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Depressive symptomatology in IBD patients is known to predict disease activity, which in turn can increase depressive symptoms in a perpetuating a cycle between depression and IBD symptomatology. The mechanisms that contribute to the relationship between disease activity and depressive symptoms are not clearly investigated yet. Since emotion regulation has been considered particularly relevant to define the impact of adverse experiences on different outcomes, the current study aimed to examine the longitudinal influence of two maladaptive emotion regulation processes, cognitive fusion and brooding, on the association between disease activity and depressed mood. This study was conducted over an 18-month period, using a sample of 116 IBD patients that completed self-report validated measures in three different waves.Correlation analyses and cross-lagged panel models were performed.The main result from this study discovered that the experience of IBD symptomatology at baseline, although positively linked to the manifestation of depressed mood 18 months later (r = 0.25; p < 0.01), does not directly predict depressive symptoms.This relationship is rather indirect, as it is explained by the engagement in cognitive fusion (p = 0.028) and brooding (p = 0.017). These maladaptive emotion regulation processes, that were revealed to be consistent over time, link IBD symptoms with subsequent depressed mood.These findings indicate that clinicians should be aware of the emotion regulation processes patients tend to use to handle difficult experiences. The inclusion of 4 psychological assessments and interventions in the healthcare of IBD patients should be seriously considered. Further implications are discussed.

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“…Sensitivity analyses 5-22: other deterministic sensitivity analyses (medical and surgical options) Table 83 presents the results of the remaining deterministic sensitivity analysis (analyses [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

Section: Assessment Group Model Resultsmentioning

confidence: 99%

Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy (including a review of TA140 and TA262): clinical effectiveness systematic review and economic model

Archer

Tappenden

Ren

et al. 2016

Health Technol Assess

143

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BackgroundUlcerative colitis (UC) is the most common form of inflammatory bowel disease in the UK. UC can have a considerable impact on patients’ quality of life. The burden for the NHS is substantial.ObjectivesTo evaluate the clinical effectiveness and safety of interventions, to evaluate the incremental cost-effectiveness of all interventions and comparators (including medical and surgical options), to estimate the expected net budget impact of each intervention, and to identify key research priorities.Data sourcesPeer-reviewed publications, European Public Assessment Reports and manufacturers’ submissions. The following databases were searched from inception to December 2013 for clinical effectiveness searches and from inception to January 2014 for cost-effectiveness searches for published and unpublished research evidence: MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library including the Cochrane Systematic Reviews Database, Cochrane Controlled Trials Register, Database of Abstracts of Reviews of Effects, the Health Technology Assessment database and NHS Economic Evaluation Database; ISI Web of Science, including Science Citation Index, and the Conference Proceedings Citation Index-Science and Bioscience Information Service Previews. The US Food and Drug Administration website and the European Medicines Agency website were also searched, as were research registers, conference proceedings and key journals.Review methodsA systematic review [including network meta-analysis (NMA)] was conducted to evaluate the clinical effectiveness and safety of named interventions. The health economic analysis included a review of published economic evaluations and the development of a de novo model.ResultsTen randomised controlled trials were included in the systematic review. The trials suggest that adult patients receiving infliximab (IFX) [Remicade®, Merck Sharp & Dohme Ltd (MSD)], adalimumab (ADA) (Humira®, AbbVie) or golimumab (GOL) (Simponi®, MSD) were more likely to achieve clinical response and remission than those receiving placebo (PBO). Hospitalisation data were limited, but suggested more favourable outcomes for ADA- and IFX-treated patients. Data on the use of surgical intervention were sparse, with a potential benefit for intervention-treated patients. Data were available from one trial to support the use of IFX in paediatric patients. Safety issues identified included serious infections, malignancies and administration site reactions. Based on the NMA, in the induction phase, all biological treatments were associated with statistically significant beneficial effects relative to PBO, with the greatest effect associated with IFX. For patients in response following induction, all treatments except ADA and GOL 100 mg at 32–52 weeks were associated with beneficial effects when compared with PBO, although these were not significant. The greatest effects at 8–32 and 32–52 weeks were associated with 100 mg of GOL and 5 mg/kg of IFX, respectively. For patients in remission following induction, all treatments except ADA at 8–32 weeks and GOL 50 mg at 32–52 weeks were associated with beneficial effects when compared with PBO, although only the effect of ADA at 32–52 weeks was significant. The greatest effects were associated with GOL (at 8–32 weeks) and ADA (at 32–52 weeks). The economic analysis suggests that colectomy is expected to dominate drug therapies, but for some patients, colectomy may not be considered acceptable. In circumstances in which only drug options are considered, IFX and GOL are expected to be ruled out because of dominance, while the incremental cost-effectiveness ratio for ADA versus conventional treatment is approximately £50,300 per QALY gained.LimitationsThe health economic model is subject to several limitations: uncertainty associated with extrapolating trial data over a lifetime horizon, the model does not consider explicit sequential pathways of non-biological treatments, and evidence relating to complications of colectomy was identified through consideration of approaches used within previous models rather than a full systematic review.ConclusionsAdult patients receiving IFX, ADA or GOL were more likely to achieve clinical response and remission than those receiving PBO. Further data are required to conclusively demonstrate the effect of interventions on hospitalisation and surgical outcomes. The economic analysis indicates that colectomy is expected to dominate medical treatments for moderate to severe UC.Study registrationThis study is registered as PROSPERO CRD42013006883.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Longitudinal study of quality of life and psychological functioning for active, fluctuating, and inactive disease patterns in inflammatory bowel disease

Cited by 217 publications

References 41 publications

Stress Coping, Distress, and Health Perceptions in Inflammatory Bowel Disease and Community Controls

Stress Coping, Distress, and Health Perceptions in Inflammatory Bowel Disease and Community Controls

An 18-month study of the effects of IBD symptomatology and emotion regulation on depressed mood

Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy (including a review of TA140 and TA262): clinical effectiveness systematic review and economic model

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