Profile of depression in adolescents with inflammatory bowel disease: Implications for treatment

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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“…Th e interactions between psychologic stress and the immune and digestive systems are likely to be complex and deeply intertwined ( 7,44 ).…”

Section: Inflammatory Bowel Diseasementioning

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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“…Therapeutic strategies to induce remission are critical to maximise growth potential and velocity and ensure that developmental milestones are obtained within normal timescales,15 while addressing concerns over body image 16. Corticosteroid use can result in stunted growth and puberty in AYP and is associated with reduced quality of life and an increased psychological distress and depression 17 18. Healthcare providers in adult and paediatric settings must monitor growth, pubertal development and related psychological morbidity.…”

Section: Monitoring Clinical Disease In Ayp With Ibdmentioning

confidence: 99%

Monitoring adolescents and young people with inflammatory bowel disease during transition to adult healthcare

Brooks

Smith

Lindsay

2017

Frontline Gastroenterol

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The transition of adolescents and young people (AYP) with inflammatory bowel disease (IBD) from paediatric to adult healthcare requires coordination between healthcare care providers to achieve optimum outcomes. Transition into adulthood is a time of major challenges physically, developmentally, emotionally and psychosocially for AYP living with IBD. Healthcare professionals must monitor the AYP progress proactively with attention to each of these parameters throughout the transition period to ensure that milestones are attained, and skills for self-management are formed. Thus, achieving the desired goals in both clinical and pastoral areas requires intensive monitoring from a multidisciplinary team across healthcare providers.

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“…Sleep disturbances have been associated with the exacerbation of chronic inflammation, especially related to pain and fatigue, and a decreased health-related quality of life. In a pediatric population of 283 patients with IBD, Szigethy et al reported difficulty sleeping in 60% of patients, and 45% of patients reported fatigue on a clinical disease index [49] . Animal models have shown that the cytokine-mediated inflammatory response that occurs in IBD induces lethargy and hypersomnia.…”

Section: Sleep Deprivation and Ibdmentioning

confidence: 99%

“…placebo response) all are related to the concept that stress reduction will improve not only the patients' sense of well being, but potentially their chronic inflammatory disease. New data by Szigethy and colleagues have suggested that the use of cognitive behavioral therapy, which is a well established approach for stress reduction, and relaxation therapy may actually help resolve depression in adolescents with IBD [49,52,53] . These investigators were also able to demonstrate in preliminary data that children receiving cognitive behavioral therapy were also shown to decrease C reactive protein elevation in a pilot study.…”

Section: Cognitive Behavioral Therapy/stress Coping In Ibdmentioning

confidence: 99%

“…Medications such as corticosteroids are implicated in the exacerbation of depression. Sleep deprivation is now being identified as a contributing factor in patients with depression in the setting of IBD [49,52,53] . Recognizing and tailoring a treatment regimen to patients suffering from concomitant depression and IBD is an important treatment goal, which may ultimately impact the clinical course of IBD.…”

Section: Depression and Supportive Psychotherapymentioning

confidence: 99%

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Supportive Therapy in IBD: What Additional Diagnoses and Conditions Must Be Treated?

Swoger¹,

Binion²

2010

Dig Dis

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Despite advances in our understanding of inflammatory bowel disease (IBD) pathogenesis and increased ability to treat patients with severe and refractory disease, patients continue to suffer from disease complications, and increasing numbers of both Crohn’s disease (CD) and ulcerative colitis (UC) patients are admitted annually in the USA. The rapid evolution in IBD medications and treatment paradigms has contributed to a disparity in clinical care which may vary between expert centers routinely treating large numbers of IBD patients and hospitals with low annual IBD admissions. High-volume centers handling in excess of 150 IBD annual admissions have improved operative and inpatient outcomes compared with hospitals caring for IBD patients less frequently. Although the precise reason for this disparity in clinical outcomes is not known, we hypothesize that expert centers provide superior IBD supportive therapy. This supportive care includes additional diagnostic and therapeutic approaches to help patients achieve optimal outcomes. We review information regarding disparities in the quality of IBD clinical care then focus on supportive therapy for IBD patients, including diagnostic approaches to identify confounding factors contributing to poor IBD outcome, supportive therapeutic approaches to optimize the outcome in hospitalized IBD patients, and future directions exploring brain-body interaction in the treatment of pain, stress and sleep deprivation in patients suffering from IBD.

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Profile of depression in adolescents with inflammatory bowel disease: Implications for treatment

Abstract: Background-The purpose was to determine the utility of including neurovegetative symptoms in assessments of depression in youth with inflammatory bowel disease (IBD).

Cited by 41 publications

References 17 publications

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

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

Monitoring adolescents and young people with inflammatory bowel disease during transition to adult healthcare

Supportive Therapy in IBD: What Additional Diagnoses and Conditions Must Be Treated?

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