Psychiatric morbidity after surgery for inflammatory bowel disease: A systematic review

Zangenberg, Marie Strøm; El‐Hussuna, Alaa

doi:10.3748/wjg.v23.i48.8651

Cited by 18 publications

(18 citation statements)

References 22 publications

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“…The depression degree in CD patients with ostomy showed statistically significant differences depending on marital status, monthly household income, length of sleep, and sleep disorder. This supports results from previous studies reporting marital and financial status as depression factors in CD patients . CD patients were almost younger than UC patients, and therefore, half the number of participants (32 patients, 50%) responded that they have a job and are in a phase of life wherein vigorous economic activity is required.…”

Section: Discussionsupporting

confidence: 89%

“…This supports results from previous studies reporting marital and financial status as depression factors in CD patients. 4,23,29 CD patients were almost younger than UC patients, and therefore, half the number of participants (32 patients, 50%) responded that they have a job and are in a phase of life wherein vigorous economic activity is required. These results are also related to financial status that a comparatively higher number of CD patients with ostomy are unmarried than UC patients with ostomy.…”

Section: Discussionmentioning

confidence: 99%

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Depression and resilience in ulcerative colitis and Crohn's disease patients with ostomy

Hwang

2019

International Wound Journal

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The purpose of this study is to identify the degree of depression and resilience in ulcerative colitis (UC) and Crohn's disease (CD) patients with ostomy and describe the correlation between depression and resilience in UC and CD patients with ostomy. 24 UC patients and 66 CD patients with ostomy were recruited from Metropolitan Hospital in Seoul, Korea. The total mean scores of depression and resilience in UC patients were 13.42 and 123.75, respectively, and in CD patients with ostomy they were 14.24 and 119.18, respectively. Depression and resilience in UC patients with ostomy were not correlated with general characteristics. Depression in CD patients with ostomy correlated with marital status (t = 2.27, P = 0.027), economic status (F = 3.98, P = 0.012), sleep disorder (t = 4.73, P < 0.001), and sleep time (t = 2.11, P = 0.039). Resilience in UC patients with ostomy correlated with religion (t = 2.47, P = 0.016), marital status (t = −3.61, P = 0.001), economic status (F = 4.06, P = 0.011), and sleep disorder (t = −3.11, P = 0.003). Significant negative correlation was found between depression and resilience in UC (r = −0.668, P < 0.001) and CD patients with ostomy (r = −0.604, P < 0.001). We recommend counselling to wound ostomy continence nurses (WOCNs) about their goal setting, facilitating adaptation of disease and ostomy in clinical setting. And we expect that WOCNs adopt a formalised and tailored long‐term approach or program to follow up for UC and CD patients with ostomy.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Depression and resilience in ulcerative colitis and Crohn's disease patients with ostomy

Hwang

2019

International Wound Journal

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“…The correlation between the greater extension of the disease and psychopathological severity reinforces the already-discussed differences relative to the group of patients suffering from CD. The evidence of correlation between depressive symptoms and surgical interventions ( 57 , 58 ) was confirmed and was shown to be more frequent in patients of CD, in comparison to those affected by UC, causing worse effects on the quality of life. These symptoms could explain the greater use of antidepressant medications in patients suffering from CD ( 59 ).…”

Section: Discussionmentioning

confidence: 83%

Alexithymia and Psychopathology in Patients Suffering From Inflammatory Bowel Disease: Arising Differences and Correlations to Tailoring Therapeutic Strategies

et al. 2018

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Comorbidity with anxiety or depression is common in patients with Inflammatory Bowel Disease (IBD) as Crohn Disease (CD) and Ulcerative Colitis (UC). Data suggest that the cognitive construct of alexithymia has high prevalence in people suffering from anxiety and mood disorders and even in people with IBD. Most studies have investigated mainly anxiety and depression, considering IBD population as a homogeneous group of patients. Little evidence shows the impact of alexithymia on the course of IBD. We evaluated a broad spectrum of psychopathological symptoms and alexithymia levels in a group of outpatients affected by IBD in clinical remission, comparing CD and UC and investigating the relationship with clinical and socio-demographic variables. One hundred and seventy IBD outpatients were screened by using the Hospital Anxiety Depression Scale (HADS), the Self-report Symptom Inventory-90-Revised (SCL-90-R) and the Toronto Alexithymia Scale (TAS-20). A high prevalence of anxious and depressive symptoms (42.35 and 25.8% respectively) together with alexithymia (31.76%) was confirmed. CD patients experienced high levels of depression (HADS Depression 35.2% p = 0.034; SCL-90-R mean 1.39 p < 0.001), somatisation (SCL-90-R mean 1.04 p < 0.001), obsessive-compulsive symptoms (SCL-90-R mean 1.2 p < 0.001), and global severity (SCL-90-R mean 1.15 p < 0.001). There is no statistical difference in the prevalence of alexithymia in both subpopulations. The levels of alexithymia are correlated to the levels of anxiety (HADS Anxiety rs = 0.516 p < 0.001), depression (HADS Depression rs = 0.556 p < 0.001; SCL-90-R rs = 0.274 p = 0.001), somatisation (SCL-90-R rs = 0.229 p = 0.005), obsessive-compulsive symptoms (SCL-90-R rs = 0.362 p < 0.001), and global severity (SCL-90-R rs = 0.265 p = 0.001). Furthermore, alexithymia is associated with a delay of diagnosis of IBD, poly-therapies and greater IBD extension. Older age, female gender, greater IBD extension, surgery, and delay of diagnosis seem to be related to a high prevalence of psychopathological symptoms such as anxiety, depression, somatisation, and obsessive-compulsive symptoms. Psychopathological symptoms and high levels of alexithymia are frequent in IBD patients and seem to be related to a high risk of poor clinical outcome. CD patients could be considered at higher risk of mental comorbidity. A more comprehensive psychiatric assessment, including alexithymia, and an integrated treatment of underlying conditions, must be taken into account in order to improve the global prognosis of the disease.

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“…Early surgical intervention after non-response to medical treatment as well as pre-operative optimization might therefore be beneficial in this group[25], especially when standard optimization schemes are implemented[26]. Patients with CD have higher risk for post-operative psychiatric morbidity[27] which might be a factor influencing LOS in this group of patients.…”

Section: Discussionmentioning

confidence: 99%

Patients with Crohn’s disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications’ rate

Grandt¹,

El‐Hussuna²,

Frasson

et al. 2019

WJGS

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BACKGROUND Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn’s disease (CD) and malignant ones like colon cancer (CC). AIM To investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD. METHODS This is a sub-group analysis of the European Society of Coloproctology’s prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission. RESULTS Three hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC ( P < 0.01), had lower American Society of Anesthesiology score (ASA) grade ( P < 0.01) and less comorbidity ( P < 0.01), but were more likely to be current smokers ( P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons ( P < 0.01) and frequently underwent ileocecal resection ( P < 0.01) with higher rate of de-functioning/primary stoma construction ( P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers. CONCLUSION Patients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complications' rate was not different between the two groups.

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Psychiatric morbidity after surgery for inflammatory bowel disease: A systematic review

Cited by 18 publications

References 22 publications

Depression and resilience in ulcerative colitis and Crohn's disease patients with ostomy

Depression and resilience in ulcerative colitis and Crohn's disease patients with ostomy

Alexithymia and Psychopathology in Patients Suffering From Inflammatory Bowel Disease: Arising Differences and Correlations to Tailoring Therapeutic Strategies

Patients with Crohn’s disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications’ rate

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