Gut Liver.  2020 Jul;14(4):459-467. 10.5009/gnl19107.

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

Affiliations
  • 1Center for Crohn’s and Colitis, Department of Gastroenterology, Kyung Hee University College of Medicine, Korea
  • 2Department of Medicine, Sungkyunkwan University School of Medicine, Korea
  • 3Department of Internal Medicine, Seoul National University College of Medicine, Korea
  • 4Department of Gastroenterology, University of Ulsan College of Medicine, Korea
  • 5Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Korea
  • 6Department of Internal Medicine, Ewha Womans University College of Medicine, Korea
  • 7Department of Internal Medicine, College of Medicine, The Catholic University of Korea
  • 8Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Korea
  • 9Department of Gastroenterology and Hepatology, Korea University College of Medicine, Korea
  • 10Department of Internal Medicine, Eulji University School of Medicine, Korea
  • 11Department of Internal Medicine, Yonsei University College of Medicine, Janssen Korea, Seoul, Korea
  • 12Department of Internal Medicine, Yonsei University College of Medical Affairs, Janssen Korea, Seoul, 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.

Keyword

Colitis, ulcerative; Patient reported outcome measures; Quality of life; Anxiety; Depression
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