Risk factors of psychological disorders in inflammatory bowel disease in a tunisian survey. results of a cross-sectional study.

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Published Mar 9, 2015
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Vol. 92 No. 12 (2014): Issue Dec 2014

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Ennaifer Rym
Elleuch Nour
Cheikh Myriam
Hefaiedh Rania
Romdhane Hayfa
Ben Nejma Houda
Belhadj Najet

Abstract

Background: Little is known in inflammatory bowel disease (IBD) regarding risk factors for psychological distress. The aims of our work were to evaluate the frequency of anxiety and depression among patients with IBD and to determine the factors associated with these psychological disorders in Tunisian patients.

Methods: From June 2012 to April 2013, 60 consecutive patients with IBD answered a questionnaire about psychological and socioeconomic factors and adherence to treatment. In this study we focused the analysis on the characteristics of IBD (type, localization, severity, treatment) and socioeconomic factors (professional, educational, and marital status). Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS).

Results: According to the HADS, 25 patients (41.6%) were anxious while 4 (6.6%) were depressed. Three had anxiety and depression at the same time. Twelve patients had a probable anxiety, 2 patients had a probable depression and 3 patients had a probable depression and anxiety at the same time. By univariate analysis, factors associated with anxiety and depression were: female gender (p<0.03), rent (p<0.03), high school graduation (p<0.009), IBD type ulcerative colitis (p<0.05). By multivariate analysis, independent factors associated with these emotional disorders were: female gender (p=0.005, OR 11.3), the high school graduation (p=0.004, OR 12.1).

Conclusion: In our cohort, risk factors for anxiety and depression were the high school graduation and IBD type ulcerative colitis. Consequently, psychological interventions would be useful when these factors are identified.

Keywords:

Anxiety, depression, risk factors, inflammatory bowel disease

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References

  1. Laktos PL. Recent trends in the epidemiology of inflammatory bowel disease/Up or down? World J Gastroenterol 2006;12:6102-8.
  2. Stone MA, Mayberry JF, Baker R. Prevalence and management of inflammatory bowel disease: a cross-sectional study from central England. Eur J Gastroenterol Hepatol 2003;15:1275-80
  3. Graff LA, Walker JR, Bernstein CN. It's not just about the gut: managing depression and anxiety in inflammatory bowel disease. Practical Gastroenterology 2010;34:11-25
  4. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scandin 1983;67: 361-70
  5. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the hospital anxiety and depression scale: an updated literature review. J Psychosom Res 2002;52:69-77.
  6. Crane C, Martin M. Social learning, affective state and passive coping in irritable bowel syndrome and inflammatory bowel disease. Gen Hosp Psychiatry 2004;26:50-8
  7. Guthrie E, Jackson J, Shaffer J, Thompson D, Tomenson B, Creed F. Psychological disorder and severity of inflammatory bowel disease predict health-related quality of life in ulcerative colitis and Crohn's disease. Am J Gastroenterol 2002;97:1994-9
  8. Helzer JE, Chammas S, Norland CC. A study of the association between Crohn's disease and psychiatric illness. Gastroenterology 1984;86:324- 30.
  9. Froch B, Zwolinska-Wcis o M, Betkowska-Korpa a B, Mach T. The dynamics of emotional reactions in patients with inflammatory bowel disease. Przeglad Gastroenterologiczny 2009;4:141-6
  10. Hardt J, Conrad S, Muche-Borowski C, Raspe H. Epidemiology of depression and distress in patients with inflammatory bowel disease and validation of an indicator scale of perceived stress for psychological impairments. Eur Psychiatry 2011;26:2217-25.
  11. Karoui S, Fakhfakh R, Daly S, Ben Hriz F, Boubaker J, Filali A. Evaluation of psychological disorders in Tunisian patients with inflammatory bowel disease. A comparative case-control study. Tunis Med 2006;84:768-71
  12. Ben Thabet J, Charfi N, Mnif L, et al. Emotional disorders and inflammatory bowel disease. Tunis Med 2012;90:557-63.
  13. Mittermaier C, Dejaco C, Waldhoer T, et al. Impact of depressive mood on relapse in patients with inflammatory bowel disease: a prospective 18-month follow-up study. Psychosom Med 2004;66:79-84
  14. Nahon S, Lahmek P, Durance C, et al. Risk Factors of Anxiety and Depression in Inflammatory Bowel Disease. Inflamm Bowel Dis 2012;18: 2086-91
  15. Mikocka-Walus AA, Turnbull DA, Andrews JM, et al. Psychological problems in gastroenterology outpatients: a South Australian experience. Psychological co-morbidity in IBD, IBS and hepatitis C. Clinic Pract Epidemiol Ment Health 2008;4- 15
  16. Addolorato G, Capristo E, Stefanini GF, Gasbarrini G. Inflammatory bowel disease: a study of the association between anxiety and depression, physical morbidity, and nutritional status. Scand J Gastroenterol 1997;32:1013-21
  17. Kurina LM, Goldacre MJ, Yeates D, Gill LE. Depression and anxiety in people with inflammatory bowel disease. J Epidemiol Community Health 2001;55:716-20
  18. Arfaoui D, Elloumi H, Debbebi W, Bel Hadj Ali N, Ajmi S. Psychological disorder associated to inflammatory bowel disease. Tunis Med 2007;85:189-91.
  19. Selinger CP, Lal S, Eaden J,et al. Better disease specific patient knowledge is associated with greater anxiety in inflammatory bowel disease. J Crohn Colitis 2013;7:214-8.
  20. Tarter RE, Switala J, Carra J, Edwards KL, and Van Thiel DL. Inflammatory bowel disease: psychiatric status of patients before and after disease onset. Int J Psychiatry Med 1987;17:173-81
  21. Iglesias M, Barreiro de Acosta M, Vazquee I. Psychological impact of Crohn's disease on patients in remission: anxiety and depression risks. Rev Esp Enferm Dig 2009;101:249-57.