The influence of depression on quality of life in patients with inflammatory bowel disease.
The influence of depression on quality of life in patients with inflammatory bowel disease.
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DOI：
10.1097/mib.0b013e318281f395
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发表时间：
2013-07
影响因子：
4.9
通讯作者：
Proctor DD
中科院分区：
文献类型：
--
作者：
Zhang CK;Hewett J;Hemming J;Grant T;Zhao H;Abraham C;Oikonomou I;Kanakia M;Cho JH;Proctor DD
炎症性肠病（IBD）是一种严重影响健康相关生活质量（HR-QOL）的胃肠道慢性炎症性疾病。与缓解期患者相比，活动性疾病患者的HR-QOL降低。在这项横断面研究中，我们研究了抑郁和疾病活动作为独立因素在预测患者HR-QOL中的作用。入选了105例克罗恩病（CD）或溃疡性结肠炎（UC）患者。用克罗恩病活动指数（CDAI）或Seo活动指数（SAI）评价疾病活动性。采用贝克抑郁量表II（BDI-II）和初级保健（BDI-PC）评估抑郁症状。采用简明炎症性肠病问卷（SIBDQ）评价HR-QOL。以多个人口统计学和临床变量作为预测因素，对生活质量评分进行简单和多元回归分析。在我们的研究人群中，抑郁症的患病率为25%。在CD和UC患者中，抑郁是HR-QOL较差的最显著预测因素（CD，P=8.22×10-6; UC，P=2.02×10-6）。HR-QOL受疾病活动性的影响较弱（CD，P=0.110; UC，P=0.00492）。在CD中，生物制品的使用对HR-QOL显示出积极影响（P=0.00780）。总的来说，所有预测因子解释的方差比例为CD的61%和UC的53%，而抑郁症单独解释44%和36%。我们的研究证明了抑郁对IBD患者生活质量的重要性。抑郁症的诊断应积极寻求和治疗IBD门诊实践。
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract that significantly impacts the health-related quality of life (HR-QOL). A decreased HR-QOL has been demonstrated in patients with active disease compared to patients in remission. In this cross-sectional study, we examined the role of depression and disease activity as independent factors in predicting patient's HR-QOL. 105 patients with either Crohn's disease (CD) or Ulcerative Colitis (UC) were enrolled. Disease activity was evaluated by the Crohn's disease activity index (CDAI) or Seo Activity Index (SAI). Depressive symptoms were evaluated by Beck's Depression Inventory II (BDI-II) and Primary Care (BDI-PC). HR-QOL was evaluated by the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Simple and multiple regressions were performed on quality of life score with multiple demographic and clinical variables as predictors. The prevalence of depression in our study population is 25%. In both CD and UC patients, depression is the most significant predictor to a poor HR-QOL (in CD, P=8.22×10-6; in UC, P=2.02×10-6). HR-QOL is weakly affected by disease activity (in CD, P=0.110; in UC, P=0.00492). In CD, Biologic use displays positive effect on HR-QOL (P=0.00780). In total, the proportion of variance explained by all predictors is 61% for CD and 53% for UC, while the depression alone explains 44% and 36%. Our study demonstrates the importance of depression toward the quality of life in IBD patients. The diagnosis of depression should be actively sought out and treated in outpatient IBD practices.