J Korean Acad Nurs.  2012 Apr;42(2):207-216. 10.4040/jkan.2012.42.2.207.

Depression and Risk Factors in Patients with Crohn's Disease

• Cho OH
• Yoo YS
• Yang SK

• KMID: 1376062
• DOI: http://doi.org/10.4040/jkan.2012.42.2.207

Abstract

PURPOSE
This study was conducted to determine the risk factors among patients with depression with Crohn's disease.
METHODS
Data were collected by questionnaire from 276 patients who were diagnosed with Crohn's disease at a tertiary hospital located in Seoul. Measurements included patients' demographic characteristics, clinical characteristics, depression level, and health-related quality of life. Data were analyzed using t-test, chi2-test, Wilcoxon rank sum test, and logistic regression analyses.
RESULTS
The incidence rate of depression (BDI-II> or =14scores) was 31.9% (n=88). Univariate analysis revealed that being a woman, school graduation status, economic status (low), BMI(<18.5Kg/m2), disease duration (> or =3 years), CDAI (> or =150 scores), frequency of hospital admission (> or =2), extra-intestinal manifestation (arthralgia, stomatitis), administration of 5-aminosalicylic acid, and disease related quality of life (SIBDQ<50 scores) were associated with depression. Multivariate analysis revealed that economic status (low), school graduation status, and quality of life (SIBDQ<50 scores) were more likely to report high level of depression.
CONCLUSION
Future research should consider managing depression as an essential component of comprehensive care for patients with Crohn's disease. In addition, further research is needed to develop strategies to better improve quality of life among patients with Crohn's disease who are depressed.

Keyword

Crohn's disease; Depression; Risk factors

MeSH Terms

Adult
Arthralgia/etiology
Body Mass Index
Crohn Disease/complications/drug therapy/*psychology
*Depression
Female
Humans
Logistic Models
Male
Mesalamine/therapeutic use
Quality of Life
Questionnaires
Risk Factors
Socioeconomic Factors
Stomatitis/etiology
Young Adult

Reference

1. Beaulieu D.B., Kane S. Inflammatory bowel disease in pregnancy. Gastroenterology Clinics of North America. 2011. 40:399–413. http://dx.doi.org/10.1016/j.gtc.2011.03.006.

2. Beck A.T., Steer R.A., Brown G.K. BDI-II, beck depression inventory: Manual. 1996. 2nd ed. San Antonio, TX: Psychological Corporation.

3. Cosnes J., Gower-Rousseau C., Seksik P., Cortot A. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology. 2011. 140:1785–1794. http://dx.doi.org/10.1053/j.gastro.2011.01.055.

4. Dutton G.R., Grothe K.B., Jones G.N., Whitehead D., Kendra K., Brantley P.J. Use of the Beck Depression Inventory-II with African American primary care patients. General Hospital Psychiatry. 2004. 26:437–442. http://dx.doi.org/10.1016/j.genhosppsych.2004.06.002.

5. Ephgrave K. Extra-intestinal manifestations of Crohn's disease. Surgical Clinics of North America. 2007. 87:673–680. http://dx.doi.org/10.1016/j.suc.2007.03.003.

6. Faul F., Erdfelder E., Buchner A., Lang A.G. Statistical power analyses using G^*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009. 41:1149–1160. http://dx.doi.org/10.3758/BRM.41.4.1149.

7. Fuller-Thomson E., Sulman J. Depression and inflammatory bowel disease: Findings from two nationally representative Canadian surveys. Inflammatory Bowel Diseases. 2006. 12:697–707. http://dx.doi.org/10.1097/00054725-200608000-00005.

8. Goh J., O'Morain C.A. Nutrition and adult inflammatory bowel disease. Alimentary Pharmacology and Therapeutics. 2003. 17:307–320. http://dx.doi.org/10.1046/j.1365-2036.2003.01482.x.

9. Graff L.A., Walker J.R., Bernstein C.N. Depression and anxiety in inflammatory bowel disease: A review of comorbidity and management. Inflammatory Bowel Diseases. 2009. 15:1105–1118. http://dx.doi.org/10.1002/ibd.20873.

10. Iglesias M., Barreiro de Acosta M., Vázquez I., Figueiras A., Nieto L., Lorenzo A., et al. Psychological impact of Crohn's disease on patients in remission: Anxiety and depression risks. Revista Espanola de Enfermedades Digestivas. 2009. 101:249–257.

11. Irvine E.J., Zhou Q., Thompson A.K. The Short Inflammatory Bowel Disease Questionnaire: A quality of life instrument for community physicians managing inflammatory bowel disease. CCRPT Investigators. Canadian Crohn's Relapse Prevention Trial. The American Journal of Gastroenterology. 1996. 91:1571–1578.

12. Kang E.H. Nutritional state of the patients with Crohn's disease in Korea. 2002. Seoul: Ewha Womans University;Unpublished master's thesis.

13. Kim H.S., Shin Y.J., Cho M.R., Kim H.J., Lim B.O., Choue R. Analysis of dietary patterns and cytokine levels in patients with inflammatory bowel disease in Korea. Korean Association for the Study of Intestinal Research. 2003. 2:168–178.

14. Kim M.S., Lee I.S., Lee C.S. The validation study I of Korean BDI- II: In female university students sample. Korean Journal of Clinical Psychology. 2007. 26:997–1014.

15. Kim Y.N. A study on the quality of life of the patients with Crohn's disease. 2010. Seoul: Chung-Ang University;Unpublished master's thesis.

16. Korean Association for the Study of the Intestinal Diseases. Crohn's disease. 2003. Seoul: Jin.

17. Lam M.Y., Lee H., Bright R., Korzenik J.R., Sands B.E. Validation of interactive voice response system administration of the Short Inflammatory Bowel Disease Questionnaire. Inflammatory Bowel Diseases. 2009. 15:599–607. http://dx.doi.org/10.1002/ibd.20803.

18. Lee S.Y. Stress and health-related quality of life in patients with IBD. 2010. Seoul: Ewha Womans University;Unpublished master's thesis.

19. Lee Y.J., Oh S.H., Kim K.M. The principles of drug therapy of Crohn's disease in child and adolescent. Korean Journal of Pediatric Gastroenterology and Nutrition. 2010. 13:suppl 1. S59–S69. http://dx.doi.org/10.5223/kjpgn.2010.13.Suppl1.S59.

20. Mittermaier C., Dejaco C., Waldhoer T., Oefferlbauer-Ernst A., Miehsler W., Beier M., et al. Impact of depressive mood on relapse in patients with inflammatory bowel disease: A prospective 18-month follow-up study. Psychosomatic Medicine. 2004. 66:79–84. http://dx.doi.org/10.1097/01.PSY.0000106907.24881.F2.

21. Moscandrew M., Mahadevan U., Kane S. General health maintenance in IBD. Inflammatory Bowel Diseases. 2009. 15:1399–1409. http://dx.doi.org/10.1002/ibd.20944.

22. Nordin K., Påhlman L., Larsson K., Sundberg-Hjelm M., Lööf L. Health-related quality of life and psychological distress in a population-based sample of Swedish patients with inflammatory bowel disease. Scandinavian Journal of Gastroenterology. 2002. 37:450–457. http://dx.doi.org/10.1080/003655202317316097.

23. Park J.B., Yang S.K., Myung S.J., Byeon J.S., Lee Y.J., Lee G.H., et al. Clinical characteristics at diagnosis and course of Korean patients with Crohn's disease. The Korean Journal of Gastroenterology. 2004. 43:8–17.

24. Rodkjaer L., Laursen T., Balle N., Sodemann M. Depression in patients with HIV is under-diagnosed: A cross-sectional study in Denmark. HIV Medicine. 2010. 11:46–53. http://dx.doi.org/10.1111/j.1468-1293.2009.00741.x.

25. Rose M., Hildebrandt M., Fliege H., Seibold S., Mönnikes H., Klapp B.F. T-cell immune parameters and depression in patients with Crohn's disease. Journal of Clinical Gastroenterology. 2002. 34:40–48. http://dx.doi.org/10.1097/00004836-200201000-00008.

26. Rowland S.M., Lam C.S., Leahy B. Use of the Beck depression inventory-II (BDI-II) with persons with traumatic brain injury: Analysis of factorial structure. Brain Injury. 2005. 19:77–83. http://dx.doi.org/10.1080/02699050410001719988.

27. Ryu K.H., Oh K.J. Effect of depressive mood on identification of emotional facial expression. Korean Journal of the Science of Emotion and Sensibility. 2008. 11:11–21.

28. Scheper H.J., Brand H.S. Oral aspects of Crohn's disease. International Dental Journal. 2002. 52:163–172. http://dx.doi.org/10.1111/j.1875-595X.2002.tb00622.x.

29. Yang S.K., Yun S., Kim J.H., Park J.Y., Kim H.Y., Kim Y.H., et al. Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986-2005: A KASID study. Inflammatory Bowel Diseases. 2008. 14:542–549. http://dx.doi.org/10.1002/ibd.20310.

30. Ye B.D., Jang B.I., Jeen Y.T., Lee K.M., Kim J.S., Yang S.K. Diagnostic guideline of Crohn's disease. The Korean Journal of Gastroenterology. 2009. 53:161–176.