Association Between Affective-Cognitive Symptoms of Depression and Exacerbation of Crohn's Disease.
Am J Gastroenterol 2016;
111:864-70. [PMID:
27045927 PMCID:
PMC4965803 DOI:
10.1038/ajg.2016.98]
[Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 02/01/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVES
The prevalence of depression is high in patients with Crohn's disease (CD). We examined the influence of affective-cognitive symptoms of depression on the risk of exacerbation of CD.
METHODS
We studied 2,144 adult volunteers with a self-reported diagnosis of CD who completed a baseline survey that included demographics, CD status, and an affective-cognitive index of depression. Linear and logistic regression analyses were used to determine whether CD status at 12 months was associated with the baseline measure of depression. Analyses were adjusted for confounders including age, gender, race, baseline disease activity, disease duration, prior hospitalization and surgery, corticosteroid and anti-TNF use, medication adherence, body mass index, current smoking, education, and sleep quality.
RESULTS
Depression was significantly associated with subsequent increases in SCDAI score in both unadjusted (P<0.001) and adjusted (P<0.001) analyses. This association was non-linear, with a shallower slope for lower levels of depression. A 10-point increase in depression t-scores from 55 to 65 was associated with a 18.6-point increase in SCDAI (95% CI 11.5-25.6) and an odds ratio of 1.27 for SCDAI>150 at follow-up (CI: 1.01-1.60). We also found a significant association between depressive symptoms and hospitalization.
CONCLUSIONS
Cognitive-affective depressive symptoms were significantly associated with a risk of exacerbation of CD and hospitalization.
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