I am a total failure: associations between beliefs and anxiety and depression in patients with inflammatory bowel disease with poor mental quality of life

2019 ◽  
Vol 48 (1) ◽  
pp. 91-102 ◽  
Author(s):  
Floor Bennebroek Evertsz’ ◽  
Mirjam A.G. Sprangers ◽  
Laura M. de Vries ◽  
Robbert Sanderman ◽  
Pieter C.F. Stokkers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Depressive Symptoms ◽  
Psychiatric Disorders ◽  
Bowel Disease ◽  
Anxiety And Depression ◽  
Illness Beliefs ◽  
Dysfunctional Beliefs ◽  
Inflammatory Bowel

AbstractBackground:According to cognitive behavioural theory, cognitive factors (i.e. underlying general dysfunctional beliefs and (situation) specific illness beliefs) are theorized to lead to outcomes like anxiety and depression. In clinical practice, general dysfunctional beliefs are generally not tackled directly in short-term-therapy.Aims:The goal of the present study was to investigate the associations of general versus specific illness beliefs on anxiety and depressive symptoms and psychiatric disorders among a subgroup of patients with inflammatory bowel disease (IBD) with poor mental quality of life (QoL).Method:This study concerns cross-sectional data, collected at baseline from a randomized clinical trial. One hundred and eighteen patients, recruited at four Dutch hospitals, with poor QoL (score ≤23 on the mental health subscale of the Short-Form 36-item Health-Survey; SF-36) were included. General dysfunctional beliefs were measured by the Dysfunctional Attitude Scale (DAS), specific illness beliefs by the Illness Perceptions Questionnaire-Revised (IPQ-R), anxiety and depressive symptoms by the Hospital Anxiety and Depression Scale (HADS), and psychiatric disorders by the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I).Results:Univariate analyses showed associations between the level of anxiety and/or depression and general dysfunctional beliefs and four specific illness beliefs (consequences, personal control, emotional representations and treatment control). Among patients with IBD with psychiatric disorders, only the DAS was significantly associated with anxiety and depression (DAS added to IPQ-R and IPQ-R added to DAS).Conclusions:Psychological interventions may have to target general dysfunctional beliefs of patients with IBD with co-morbid psychiatric disorders to be effective. These patients with IBD are especially in need of psychological treatment.

scholarly journals TELEmedicine for Patients With Inflammatory Bowel Disease (TELE-IBD) Does Not Improve Depressive Symptoms or General Quality of Life Compared With Standard Care at Tertiary Referral Centers

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Matthew Schliep ◽  
Kenechukwu Chudy-Onwugaje ◽  
Ameer Abutaleb ◽  
Patricia Langenberg ◽  
Miguel Regueiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Depressive Symptoms ◽  
Bowel Disease ◽  
Standard Care ◽  
Text Message ◽  
Tertiary Referral ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background Depression is common in patients with inflammatory bowel disease (IBD) and contributes to poor quality of life (QoL). The use of information technology for the remote management of patients with IBD is growing, but little is known about its impact on depressive symptoms (DS) and QoL. We aimed to evaluate the impact of telemedicine on DS and generic QoL in IBD patients. Methods We analyzed data from the Telemedicine for Patients with IBD (TELE-IBD) study. During this 12-month clinical trial, patients were randomized to receive text message-based telemedicine weekly (TELE-IBD W), every other week (TELE-IBD EOW), or to standard care. Depressive symptoms and QoL were assessed over time with the Mental Health Inventory 5 (MHI-5) and the Short Form 12 (SF-12), respectively. We compared the change in MHI-5 and SF-12 (with separate physical (PCS) and mental component summary (MCS) scores) between the study arms. Results A total of 217 participants were included in this analysis. After 1 year, there was no significant difference in the change in MHI-5 (TELE-IBD W +3.0 vs TELE-IBD EOW +0.7 vs standard care +3.4; P = 0.70), MCS (TELE-IBD W +1.4 vs TELE-IBD EOW +1.0 vs standard care +2.5; P = 0.89), and PCS scores (TELE-IBD W +0.4 vs TELE-IBD EOW +0.6 vs standard care +3.7; P = 0.06) between the groups. Conclusions Text message-based telemedicine does not improve DS or QoL when compared with standard care in IBD patients treated at tertiary referral centers. Further studies are needed to determine whether telemedicine improves DS or QoL in settings with few resources.

scholarly journals Effectiveness of a Multicomponent Group Psychological Intervention Program in Patients with Inflammatory Bowel Disease: A Randomized Trial

2021 ◽  
Vol 18 (10) ◽  
pp. 5439
Author(s):  
Purificación Bernabeu ◽  
Carlos van-der van-der Hofstadt ◽  
Jesús Rodríguez-Marín ◽  
Ana Gutierrez ◽  
Miguel Raúl Alonso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Cognitive Behavioral Therapy ◽  
Disease Activity ◽  
Bowel Disease ◽  
Psychological Intervention ◽  
Behavioral Therapy ◽  
Anxiety And Depression ◽  
Inflammatory Bowel

(1) Background: Stress, anxiety, and depression have been identified as factors that influence the development of inflammatory bowel disease (IBD). The main aim of this study was to test the effectiveness of group multicomponent cognitive-behavioral therapy at reducing stress, anxiety, and depression, and improving quality of life and the clinical course of the disease. (2) Methods: A total of 120 patients were evaluated using the General Perceived Stress Scale, Scale of Stress Perceived by the Disease, the anxiety and depression scale, and quality of life questionnaire for patients with IBD. Disease activity was measured using the Mayo Index for ulcerative colitis and CDAI for Crohn's disease, as well as the number of relapses self-reported by patients. Patients were randomized to receive group multicomponent cognitive-behavioral therapy or treatment as usual. (3) Results: The psychological intervention reduced stress (EAE: 45.7 ± 8.8 vs. 40.6 ± 8.4, p = 0.0001; PSS: 28.0 ± 7.3 vs. 25.1 ± 5.9, p = 0.001) and improved quality of life (164.2 ± 34.3 vs. 176.2 ± 28.0, p = 0.001). An improvement was found in the number of relapses self-reported by patients (0.2 relapses/patient vs. control 0.7 relapses/patient; p = 0.027). No differences were found in disease activity indexes. (4) Conclusions: Psychological therapy was associated with improved stress, quality of life and with a decrease in the number of relapses self-reported by patients. Clinical trial registration number: NCT02614014

scholarly journals P247 Sex-related differences in clinical diagnosis of inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S271-S272
Author(s):  
L Sempere Robles ◽  
B Purificación ◽  
J Cameo ◽  
A Gutiérrez ◽  
R Laveda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Sex Differences ◽  
Gender Roles ◽  
Bowel Disease ◽  
Diagnostic Delay ◽  
Anxiety And Depression ◽  
Inflammatory Bowel ◽  
Diagnostic Resolution

Abstract Background There is a lack of knowledge of the differences between women and men in clinical behaviour at the onset of inflammatory bowel disease (IBD). We hypothesise a potential diagnostic delay in women in IBD. The aims of this study were: (1) to evaluate the differences in diagnostic effort between women and men with IBD and (2) to assess the sex differences in IBD diagnosis and its impact on the gender roles, the quality of life and the emotional sphere. Methods We performed a prospective multicentre observational study in adults with a new diagnosis of IBD. The diagnostic process of IBD was reconstructed with semistructured interviews and electronic clinical records. Time to diagnostic resolution after the onset of symptoms and misdiagnosis of IBD in the different levels of the healthcare system were analysed. Patient delay was defined as the period from symptom recognition to first medical consultation. An additional interview was conducted to assess differences between women and men in the influence of IBD in gender roles (directed questions), quality of life (IBDQ-32), anxiety and depression (Hospital Anxiety and Depression Scale) and stress (Disease-Related Stress Appreciation Scale). Results 121 patients were included (44.6% CD, 53.7% UC, 1.7% IBD-U), (43.8% women 56.2% men) (median age 43 years, 29.5–55). Time to diagnostic resolution was higher in women compared with men, 214 days (93–452) vs. 90 days (40–183) p = 0.001. These differences were more evident in CD 326 days (94–627) / 67 days (28–182) p = 0.007, than in CU 174 days (92–350) / 92 days (47–184) p = 0.078. There were no significant sex differences in patient delay. Misdiagnosis of IBD was found to be 71.7% for women and 48.5% for men (p = 0.010). Data from Table 1 and Table 2 show the sex differences in the ‘influence’ of IBD in a sample of gender roles evaluated, the quality of life and the emotional sphere. Conclusion Our results demonstrate that women with IBD show a higher diagnostic delay and misdiagnosis compared with men. This delay is more evident in CD. Moreover, there is a higher impact of IBD diagnosis in women on the gender roles, the quality of life and the emotional sphere.

scholarly journals P301 Ustekinumab improves health-related quality of life in patients with moderate-to-severe Crohn’s disease: results up to Week 48 of the STARDUST trial

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S330-S331
Author(s):  
S Danese ◽  
S Vermeire ◽  
G D’Haens ◽  
J Panés ◽  
A Dignass ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Work Productivity ◽  
Anxiety And Depression ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Inflammatory Bowel

Abstract Background A treat-to-target (T2T) strategy may optimize inflammatory bowel disease management. The STARDUST trial compared a T2T maintenance strategy against standard of care (SoC) in Crohn’s disease (CD) patients treated with ustekinumab (UST). The primary endpoint, safety, and efficacy data of STARDUST have been published previously.1 Here we present results for health-related quality of life (HRQoL) measures and impact of UST on work and activities at Week (W)48 of UST maintenance, comparing T2T and SoC. Methods Adult patients with moderate–severely active CD received iv, weight-based UST ~6 mg/kg at W0 (baseline [BL]); then SC UST 90 mg at W8. At W16, CD activity index (CDAI) 70 responders were randomized (1:1) to either T2T (maintenance dosing, q12w or q8w, assigned based on endoscopic activity and further dose escalations up to q4w if clinical and biomarker-directed targets were not met) or SoC (maintenance based on EU SmPC; q12w or q8w based on clinical judgement). In this analysis we assessed changes from BL in the following HRQoL measures at W48: Inflammatory Bowel Disease Questionnaire (IBDQ), EuroQoL 5 Dimension 5 Level (EQ-5D-5L), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) tools, and Hospital Anxiety and Depression Scale – anxiety and depression subscales (HADS-A and -D) alongside the Work Productivity and Activity Impairment (WPAI) questionnaire; time lost from work was also recorded. Percentage of patients with IBDQ response (16 point improvement from BL) and remission (IBDQ score ≥170) at W48 were also analysed. Results Of 500 patients enrolled, 441 were randomized to T2T (n=220) or SoC (n=221); 79.1% and 87.3%, respectively, completed W48. At W48, the percentage of patients in T2T and SoC arms with IBDQ response (58.2% and 67.0%, respectively) and remission (45.0% and 53.4%, respectively) were similar (both p=ns). Similar changes from BL at W48 in IBDQ, EQ-5D-5L (visual analogue scale and index score), FACIT-F, HADS-A and -D and WPAI were noted in both treatment arms (Table 1). WPAI 7-Point Improvement from BL per domain at W48 are presented in Table 2. During the last 4 weeks preceding the visit at W48, patients in T2T and SoC arms on average lost 1.7 and 2.2 fewer days from work due to CD, respectively, compared to BL (p=ns). At W48, 62.3% and 72.3% were in employment in T2T and SoC arms, respectively (p=ns), compared to 61.8% and 63.5%, respectively at BL. Conclusion UST treatment improved HRQoL and work productivity and helped decrease time lost from work in patients with moderate-to-severe CD, regardless of T2T or SoC strategy. Improvements were generally maintained up to W48. Reference

scholarly journals Su1779 – Text Message-Based Telemedicine Does Not Improve Quality of Life Or Depressive Symptoms in Inflammatory Bowel Disease Patients

2019 ◽  
Vol 156 (6) ◽  
pp. S-608
Author(s):  
Matthew Schliep ◽  
Kenechukwu Chudy-Onwugaje ◽  
Ameer Abutaleb ◽  
Patricia Langenberg ◽  
Miguel D. Regueiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Depressive Symptoms ◽  
Bowel Disease ◽  
Text Message ◽  
Improve Quality ◽  
Inflammatory Bowel
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