Unmet Psychosocial Needs of Patients with Newly Diagnosed Ulcerative Colitis: Results from the Nationwide Prospective Cohort Study in Korea

Abstract

Background/Aims: Limited data are available regarding psychosocial distress at the time of diagnosis of ulcerative colitis (UC). We investigated the psychosocial burden and factors related to poor health-related quality of life (HRQL) among patients newly diagnosed with moderate-to-severe UC who were affiliated with the nationwide prospective cohort study. Methods: Within the first 4 weeks of UC diagnosis, all patients were assessed using the Hospital Anxiety and Depression Scale (HADS), Work Productivity and Activity Impairment questionnaire, Inflammatory Bowel Disease Questionnaire (IBDQ), and 12-Item Short Form (SF-12) health survey. A multiple linear regression model was used to identify factors associated with HRQL. Results: Between August 2014 and February 2017, 355 patients completed questionnaires. Significant mood disorders requiring psychological interventions, defined by a HADS score ≥11, were identified in 16.7% (anxiety) and 20.6% (depression) of patients. Patients with severe disease were more likely to have presenteeism, loss of work productivity, and activity loss than those with moderate disease (all p<0.05). Significant mood disorders had the strongest negative relationship with total IBDQ score, which indicates disease-specific HRQL (β coefficient:-22.1 for depression and-40.0 for anxiety, p<0.001). The scores of all SF-12 dimensions, which indicate general HRQL, were remarkably decreased in the study population compared indirectly with previously reported scores in the general population. The Mayo score, C-reactive protein level, and white blood cell count showed significant negative associations with the IBDQ score (p<0.05). Conclusions: Psychosocial screening and timely interventions should be incorporated into the initial care of patients newly diagnosed with UC.

Tryptophan-kynurenine metabolism: a link between the gut and brain for depression in inflammatory bowel disease

“…The Canadian IBD cohort study suggested that patients had higher lifetime prevalence rates of generalized anxiety disorder (GAD) and major depressive disorder (MDD) than the general population at 13.4% and 27.2% [ 20 ]. This is consistent with similar results which were found in studies initiated in the USA [ 7 ], China [ 21 ], Italy [ 22 ], Ireland [ 23 ], and South Korea [ 24 ]. A systematic review that combined multiple clinical studies showed that IBD had 19.2% and 21.2% anxiety and 21.2% depression, almost twice the rate of the general population, and 66.4% anxious mood and 34.7% depression in IBD patients who were also active.…”

Early course of newly diagnosed moderate‐to‐severe ulcerative colitis in Korea: Results from a hospital‐based inception cohort study (MOSAIK)

“…The inclusion and exclusion criteria have been previously described in details. 8,9 We focused on moderate-to-severe UC patients as mild UC patients have limitations in their accuracy of diagnosis, compliance to treatment, and difficulty in long-term follow-up. Diagnosis of UC was based on a combination of conventional clinical, endoscopic, radiological, and histological criteria; symptoms consistent with UC were required to last for more than 4 weeks for the inclusion in the study, according to international criteria.…”

Work Productivity Loss in Inflammatory Bowel Disease Patients in Turkey

“…In the recent years, patient-reported outcomes (PROs) have been accepted as important endpoints in clinical trials and as treatment targets in real life. Health-related quality of life (HRQoL) is mostly known and used PRO; however, it does not focus on the working life and absenteeism and presenteeism [10].…”