Aerobic Exercise Training in Children and Adolescents with Inflammatory Bowel Disease: Influence on psychological Functioning, Sleep and Physical Performance

2017 ◽  
Vol 41 (S1) ◽  
pp. S124-S124
Author(s):  
L. Maehlmann ◽  
M. Gerber ◽  
R.I. Furlano ◽  
C. Légeret ◽  
N. Kalak ◽  
...  
Keyword(s):  
Mental Health ◽  
Inflammatory Bowel Disease ◽  
Depressive Symptoms ◽  
Exercise Training ◽  
Sleep Quality ◽  
Psychological Functioning ◽  
Aerobic Exercise Training ◽  
Subjective Sleep ◽  
Inflammatory Bowel ◽  
Active Disease

Background and aimsPatients with inflammatory bowel disease (IBD) report increased mental health issues, poorer sleep quality and less engagement in physical activity (PA). Standard treatment consists of immune modulating pharmaceuticals, though evidence is growing that aerobic exercise training (AET) might serve as adjuvant option to reduce disease symptoms and improve mental health. The aim of the present study was to investigate possible AET effects on psychological functioning, depressive symptoms, sleep and PA behavior in paediatric patients with IBD.MethodsTwenty-one paediatric patients with IBD and 23 gender and age-matched healthy controls (HC) were assessed. The IBD group was split into a “remission-group” (IBD-RE; n = 14) and an “active disease group” (IBD-AD; n = 7). All participants completed an 8-week AET exergame intervention reaching 60–80% of maximal heart rate for 5 days per week. At baseline and after 8 weeks, psychological functioning, depressive symptoms, objective sleep EEG, subjective sleep and objective and subjective PA were assessed.ResultsAET significantly improved the exercise capacity of all participants. Self-reported fitness and daily PA behavior significantly increased in IBD-AD, but not in IBD-RE and HC. No improvements were observed for psychological functioning, depressive symptoms and subjective or objective sleep dimensions. Descriptively, the IBD-AD group reported lower psychological functioning and poorer subjective sleep quality.ConclusionsResults suggest that children and adolescents in an active disease state were at increased risk to descriptively report lower scores of psychological functioning and sleep. Further, an exergaming intervention has the potential to improve exercise capacity, self-reported fitness and daily PA.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Depressive Symptoms Predict Clinical Recurrence of Inflammatory Bowel Disease

2021 ◽  
Author(s):  
Sebastian Bruno Ulrich Jordi ◽  
Brian Matthew Lang ◽  
Bianca Auschra ◽  
Roland von Känel ◽  
Luc Biedermann ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Depressive Symptoms ◽  
Bowel Disease ◽  
Strong Predictor ◽  
Clinical Deterioration ◽  
End Points ◽  
Clinical Recurrence ◽  
Inflammatory Bowel ◽  
The Impact ◽  
Active Disease

Abstract Background Inflammatory bowel disease (IBD) patients are at high risk for depression, and depression has been shown to affect disease course. We examined interrelations between depression, genetic risk factors for depression, and IBD flares. Method In 1973 patients (1137 Crohn’s disease, 836 ulcerative colitis) of the Swiss IBD Cohort Study (SIBDCS), depressive status (hospital anxiety and depression subscale for depression, HADS-D ≥11) was assessed on a yearly basis. We investigated the impact of depression on IBD-relevant clinical outcomes in Cox proportional hazards models. We used active disease (CDAI ≥150 or MTWAI ≥10) and 2 published composite flare definitions—FNCE (physician-reported flare, nonresponse to therapy, new complication, or extraintestinal manifestation) and AFFSST (active disease, physician-reported flare, fistula, stenosis, and new systemic therapy)—as clinical end points. Additionally, 62 preselected single nucleotide polymorphisms (SNPs) were screened for cross-sectional associations with depression, and if present, their predictive value for future depression and clinical deterioration was assessed. Results Depression was a strong risk factor for disease-related end points, including active disease (adjusted hazard ratio [aHR], 3.55; P < 0.001), AFFSST (aHR, 1.62; P < 0.001), and FNCE (aHR, 1.35; P = 0.019). The SNP rs2522833 was significantly associated with depression at enrollment (q = 0.059). The TC allele of rs588765 was negatively associated with the presence of depression at enrollment (q = 0.050) and after enrollment (aHR, 0.67; P = 0.035) and with fewer active disease states (aHR, 0.72; P = 0.045) during follow-up. Conclusion In IBD, depressive symptoms and inflammatory activity are intimately related. Depressive symptoms were a strong predictor of clinical deterioration, and genetic markers may play a role in this relationship.

Cannabis Use in Persons With Inflammatory Bowel Disease and Vulnerability to Substance Misuse

2019 ◽  
Vol 26 (9) ◽  
pp. 1401-1406 ◽  
Author(s):  
Tawnya M Hansen ◽  
Brigitte C Sabourin ◽  
Banke Oketola ◽  
Charles N Bernstein ◽  
Harminder Singh ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Logistic Regression ◽  
Depressive Symptoms ◽  
Bowel Disease ◽  
Substance Misuse ◽  
Cannabis Use ◽  
Factors Associated ◽  
Inflammatory Bowel

Abstract Background It is unknown whether cannabis users self-medicating their inflammatory bowel disease (IBD) symptoms are more likely to have comorbid mental health or personality risk factors associated with an increased potential for substance misuse compared with recreational cannabis users. Methods We surveyed individuals with IBD about their cannabis use, their mental health symptoms, and personality risk factors associated with substance misuse. We compared risk factors for substance misuse between individuals using cannabis to manage IBD symptoms and those using cannabis recreationally. Results Of 201 persons with IBD who completed the questionnaire, 108 reported lifetime cannabis use. Of those, a larger proportion of Crohn’s disease patients used cannabis to manage IBD symptoms (53% [34/64] vs 28% [12/43]; P = 0.010). Individuals self-medicating with cannabis were more likely to use cannabis for coping reasons (P = 0.016) and demonstrated higher levels of impulsivity (P = 0.004) and depressive symptoms (P = 0.012) when compared with individuals using cannabis recreationally. Logistic regression revealed that cannabis was 4.1 times (P = 0.05) and 3.7 times (P = 0.05) more likely to be used for IBD symptoms by smokers and individuals with moderate–severe depressive symptoms, respectively. Individuals high in impulsivity were 4.1 times more likely to use cannabis for their IBD symptoms than those low in impulsivity (P = 0.005). Conclusions Persons with IBD self-medicating with cannabis have characteristics associated with increased vulnerability to substance misuse when compared with those using cannabis recreationally. Screening for mental health comorbidities and vulnerability to substance misuse should be undertaken if cannabis is to be used to treat IBD symptoms.

scholarly journals P008 A systematic review and meta-analysis of inflammatory bowel disease activity and sleep quality

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A24-A24
Author(s):  
A Barnes ◽  
P Spizzo ◽  
R Mountifield ◽  
P Bampton ◽  
J Andrews ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Sleep Quality ◽  
Bowel Disease ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Inflammatory Bowel ◽  
Meta Analyses

Abstract Background Poor sleep quality has been associated with active inflammatory bowel disease (IBD) in several studies. This review examines sleep quality in people with active IBD and in those in remission, with meta-analyses performed, considering subjective and objective sleep quality and IBD activity. Methods Electronic databases were searched from inception to December 1st 2020. A random effects model was used with separate meta-analyses performed for objective and subjective sleep and IBD activity, considering sleep quality in active and inactive IBD. Results 19 studies were included in the qualitative review representing 4972 IBD patients. Subjective IBD activity (11 studies) was associated with subjective sleep quality with pooled odds ratio (OR) for subjective poor sleep in active IBD compared to remission of 3.04 (95% CI 2.41–3.83). Including only studies with objective sleep measures (5 studies), sleep efficiency was lower in those self-reporting active IBD and time awake post sleep onset was higher in those with active IBD. Objective IBD activity was associated with subjective poor sleep (4 studies), with pooled OR of 6.64 95% CI (3.02 – 14.59). Insufficient data was available to consider objective IBD activity and objective sleep quality. Conclusion IBD activity is associated with poor sleep using subjective and objective measures of sleep quality. This poor sleep manifests as decreased sleep efficiency and increased number of waking episodes post sleep onset. The relationship between objective IBD activity and sleep requires further investigation.

scholarly journals A172 THE ASSOCIATION OF EFFICACY, OPTIMISM, UNCERTAINTY AND HEALTH ANXIETY IN INFLAMMATORY BOWEL DISEASE ACTIVITY OVER TIME

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 183-184
Author(s):  
J Stone ◽  
L Shafer ◽  
L A Graff ◽  
K Witges ◽  
L Lix ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Psychological Functioning ◽  
Self Efficacy ◽  
Health Anxiety ◽  
Self Report ◽  
Psychological Attributes ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Aims We aimed to assess if the presence of positive or negative psychological attributes are associated with disease activity in a prospective inflammatory bowel disease (IBD) cohort using validated psychological assessment tools and various measures of disease activity. Methods The study included 146 adults with confirmed and recently active IBD enrolled in a prospective longitudinal cohort study. Demographics, disease information, validated measures of psychological functioning related to self-efficacy, optimism, health anxiety and intolerance of uncertainty were collected at baseline, week 26 and week 52. Disease activity indicators included fecal calprotection (FCAL), the Inflammatory Bowel Disease Symptom Inventory (IBDSI), and self-reported flares and were collected at study baseline, week 26 and week 52. Logistic regression was used to identify the relationship between psychological functioning and disease activity. Results Participants’ mean age was 42.9 years (SD 12.6; range 18–70), with 70.5% women. Almost two thirds (65.1%) had a diagnosis of Crohn’s disease (CD), 34.2% had ulcerative colitis (UC), and 0.7% (n=1) was IBD unclassified. 22% had income <$50,000 and 63% were in a current relationship. Patient-reported active disease (i.e., IBDSI; flare self-report) was significantly less likely with higher self-efficacy [OR= 0.87, 95% CI 0.82–0.93 (IBDSI); OR= 0.86, 95% CI 0.81–0.91 (self-report)] and significantly more likely with higher health anxiety (OR=1.09, 95% CI 1.04–1.15) with the association remaining for self-reported flares after adjusting for demographic variables. The psychological attributes were not associated with active disease based on FCAL levels. Conclusions Higher health anxiety increases the likelihood of experiencing an IBD flare, while higher general self-efficacy may be protective of a disease flare. Funding Agencies None

scholarly journals Depressive symptoms and single nucleotide polymorphisms predict clinical recurrence of inflammatory bowel disease

2020 ◽  
Author(s):  
Sebastian Bruno Ulrich Jordi ◽  
Brian Matthew Lang ◽  
Bianca Auschra ◽  
Roland von Känel ◽  
Luc Biedermann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Depressive Symptoms ◽  
Bowel Disease ◽  
Genetic Risk ◽  
Disease Course ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Inflammatory Bowel ◽  
Active Disease

AbstractBackground and AimsInflammatory bowel disease (IBD) patients are at high risk for depression. We examined interrelations between genetic risk factors for depression, depressive symptoms and IBD flares.MethodsIn 1973 patients (1137 Crohn’s disease, 836 ulcerative colitis) of the Swiss IBD cohort study (SIBDC), 62 single nucleotide polymorphisms (SNPs) preselected for associations with depression, stress, pain and smoking were screened for cross-sectional associations with depression (hospital anxiety and depression subscale for depression, HADS-D≥11). Logistic regression and Cox proportional hazards models were built to test for effects of depressive symptoms on disease course and genetic risk factors on depression and disease course. As endpoints we used active disease (CDAI≥150 or MTWAI≥10) and two published composite flare definitions: FNCE: physician reported flare, non-response to therapy, new complication or extraintestinal manifestation and AFFSST: active disease, physician reported flare, fistula, stenosis and new systemic therapy.ResultsDepressive symptoms were a strong risk factor for disease related endpoints including active disease (adjusted hazard ratio, aHR: 3.25, p<0.001), AFFSST (aHR: 1.62, p<0.001) and FNCE (aHR: 1.35, p=0.019). Rs588765’s TC alleles and rs2522833’s C allele were associated with depressive symptoms at baseline (odds ratio, OR: 0.43, q=0.050 and OR: 1.73, q=0.059, respectively). Rs588765-TC remained protective regarding presence of depression (aHR: 0.67, p=0.035) and was associated with fewer active disease states (aHR: 0.72, p=0.045) during follow-up.ConclusionsIn IBD, genetics, depressive symptoms and inflammatory activity are intimately related: Depressive symptoms were a predictor of clinical deterioration and rs588765-TC was protective for depression and high IBD activity.FundingThis work was supported by the Swiss National Science Foundation (SNSF).

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