Journal List > J Korean Acad Nurs > v.42(2) > 1002797

This article has been corrected. See "Erratum" in Volume 42 on page 452.
TOOLS
Cho, Yoo, and Yang: Depression and Risk Factors in Patients with Crohn's Disease
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2012; 42(2): 207-216.

Published online: 30 April 2012

DOI: https://doi.org/10.4040/jkan.2012.42.2.207

Depression and Risk Factors in Patients with Crohn's Disease

Ok-Hee Cho1, Yang-Sook Yoo2, Suk-Kyun Yang3

1Full-time Lecturer, College of Nursing, Jeju National University, Jeju, Korea.

2Professor, College of Nursing, The Catholic University of Korea, Seoul, Korea.

3Professor, Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Address reprint requests to: Yoo, Yang-Sook. College of Nursing, Jeju National University, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea. Tel: +82-2-2258-7411, Fax: +82-2-2258-7772, ysyoo@catholic.ac.kr

Received 8 July 2011       Accepted 26 April 2012

© 2012 Korean Society of Nursing Science

Abstract

Purpose

This study was conducted to determine the risk factors among patients with depression with Crohn's disease.

Methods

Data were collected by questionnaire from 276 patients who were diagnosed with Crohn's disease at a tertiary hospital located in Seoul. Measurements included patients' demographic characteristics, clinical characteristics, depression level, and health-related quality of life. Data were analyzed using t-test, χ2-test, Wilcoxon rank sum test, and logistic regression analyses.

Results

The incidence rate of depression (BDI-II≥14scores) was 31.9% (n=88). Univariate analysis revealed that being a woman, school graduation status, economic status (low), BMI(<18.5Kg/m2), disease duration (≥3 years), CDAI (≥150 scores), frequency of hospital admission (≥2), extra-intestinal manifestation (arthralgia, stomatitis), administration of 5-aminosalicylic acid, and disease related quality of life (SIBDQ<50 scores) were associated with depression. Multivariate analysis revealed that economic status (low), school graduation status, and quality of life (SIBDQ<50 scores) were more likely to report high level of depression.

Conclusion

Future research should consider managing depression as an essential component of comprehensive care for patients with Crohn's disease. In addition, further research is needed to develop strategies to better improve quality of life among patients with Crohn's disease who are depressed.

Keywords: Crohn's disease, Depression, Risk factors

Figures and Tables

Table 1
Comparison of General Characteristics between Patients with Depression and with no Depression (N=276)
jkan-42-207-i001

BMI=Body mass index.

Table 2
Comparison Disease-related Characteristics between Patients with Depression and with no Depression (N=276)
jkan-42-207-i002

CDAI=Crohn's disease activity index;

* Fisher's exact test; †Values are median (range); ‡Subjects may select more than one item.

Table 3
Comparison Health-related Quality of Life between Patients with Depression and with no Depression (N=276)
jkan-42-207-i003
Table 4
Risk Factors for Depression by Univariate Analysis
jkan-42-207-i004

CDAI=Crohn's Disease Activity Index; OR=Odds ratio; 95% CI=95% confidence interval; SIBDQ=Short Inflammatory Bowel Disease Questionnaire.

Table 5
Risk Factors for Depression by Multivariate Analysis
jkan-42-207-i005

SIBDQ=Short Inflammatory Bowel Disease Questionnaire; OR=Odds ratio; 95% CI=95% confidence interval.

Notes

The authors wishes to acknowledge the financial support of the Catholic Medical Center Research Foundation made in the program year of 2009.

References

1. Beaulieu D.B., Kane S. Inflammatory bowel disease in pregnancy. Gastroenterology Clinics of North America. 2011. 40:399–413. http://dx.doi.org/10.1016/j.gtc.2011.03.006.
2. Beck A.T., Steer R.A., Brown G.K. BDI-II, beck depression inventory: Manual. 1996. 2nd ed. San Antonio, TX: Psychological Corporation.
3. Cosnes J., Gower-Rousseau C., Seksik P., Cortot A. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology. 2011. 140:1785–1794. http://dx.doi.org/10.1053/j.gastro.2011.01.055.
4. Dutton G.R., Grothe K.B., Jones G.N., Whitehead D., Kendra K., Brantley P.J. Use of the Beck Depression Inventory-II with African American primary care patients. General Hospital Psychiatry. 2004. 26:437–442. http://dx.doi.org/10.1016/j.genhosppsych.2004.06.002.
5. Ephgrave K. Extra-intestinal manifestations of Crohn's disease. Surgical Clinics of North America. 2007. 87:673–680. http://dx.doi.org/10.1016/j.suc.2007.03.003.
6. Faul F., Erdfelder E., Buchner A., Lang A.G. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009. 41:1149–1160. http://dx.doi.org/10.3758/BRM.41.4.1149.
7. Fuller-Thomson E., Sulman J. Depression and inflammatory bowel disease: Findings from two nationally representative Canadian surveys. Inflammatory Bowel Diseases. 2006. 12:697–707. http://dx.doi.org/10.1097/00054725-200608000-00005.
8. Goh J., O'Morain C.A. Nutrition and adult inflammatory bowel disease. Alimentary Pharmacology and Therapeutics. 2003. 17:307–320. http://dx.doi.org/10.1046/j.1365-2036.2003.01482.x.
9. Graff L.A., Walker J.R., Bernstein C.N. Depression and anxiety in inflammatory bowel disease: A review of comorbidity and management. Inflammatory Bowel Diseases. 2009. 15:1105–1118. http://dx.doi.org/10.1002/ibd.20873.
10. Iglesias M., Barreiro de Acosta M., Vázquez I., Figueiras A., Nieto L., Lorenzo A., et al. Psychological impact of Crohn's disease on patients in remission: Anxiety and depression risks. Revista Espanola de Enfermedades Digestivas. 2009. 101:249–257.
11. Irvine E.J., Zhou Q., Thompson A.K. The Short Inflammatory Bowel Disease Questionnaire: A quality of life instrument for community physicians managing inflammatory bowel disease. CCRPT Investigators. Canadian Crohn's Relapse Prevention Trial. The American Journal of Gastroenterology. 1996. 91:1571–1578.
12. Kang E.H. Nutritional state of the patients with Crohn's disease in Korea. 2002. Seoul: Ewha Womans University;Unpublished master's thesis.
13. Kim H.S., Shin Y.J., Cho M.R., Kim H.J., Lim B.O., Choue R. Analysis of dietary patterns and cytokine levels in patients with inflammatory bowel disease in Korea. Korean Association for the Study of Intestinal Research. 2003. 2:168–178.
14. Kim M.S., Lee I.S., Lee C.S. The validation study I of Korean BDI- II: In female university students sample. Korean Journal of Clinical Psychology. 2007. 26:997–1014.
15. Kim Y.N. A study on the quality of life of the patients with Crohn's disease. 2010. Seoul: Chung-Ang University;Unpublished master's thesis.
16. Korean Association for the Study of the Intestinal Diseases. Crohn's disease. 2003. Seoul: Jin.
17. Lam M.Y., Lee H., Bright R., Korzenik J.R., Sands B.E. Validation of interactive voice response system administration of the Short Inflammatory Bowel Disease Questionnaire. Inflammatory Bowel Diseases. 2009. 15:599–607. http://dx.doi.org/10.1002/ibd.20803.
18. Lee S.Y. Stress and health-related quality of life in patients with IBD. 2010. Seoul: Ewha Womans University;Unpublished master's thesis.
19. Lee Y.J., Oh S.H., Kim K.M. The principles of drug therapy of Crohn's disease in child and adolescent. Korean Journal of Pediatric Gastroenterology and Nutrition. 2010. 13:suppl 1. S59–S69. http://dx.doi.org/10.5223/kjpgn.2010.13.Suppl1.S59.
20. Mittermaier C., Dejaco C., Waldhoer T., Oefferlbauer-Ernst A., Miehsler W., Beier M., et al. Impact of depressive mood on relapse in patients with inflammatory bowel disease: A prospective 18-month follow-up study. Psychosomatic Medicine. 2004. 66:79–84. http://dx.doi.org/10.1097/01.PSY.0000106907.24881.F2.
21. Moscandrew M., Mahadevan U., Kane S. General health maintenance in IBD. Inflammatory Bowel Diseases. 2009. 15:1399–1409. http://dx.doi.org/10.1002/ibd.20944.
22. Nordin K., Påhlman L., Larsson K., Sundberg-Hjelm M., Lööf L. Health-related quality of life and psychological distress in a population-based sample of Swedish patients with inflammatory bowel disease. Scandinavian Journal of Gastroenterology. 2002. 37:450–457. http://dx.doi.org/10.1080/003655202317316097.
23. Park J.B., Yang S.K., Myung S.J., Byeon J.S., Lee Y.J., Lee G.H., et al. Clinical characteristics at diagnosis and course of Korean patients with Crohn's disease. The Korean Journal of Gastroenterology. 2004. 43:8–17.
24. Rodkjaer L., Laursen T., Balle N., Sodemann M. Depression in patients with HIV is under-diagnosed: A cross-sectional study in Denmark. HIV Medicine. 2010. 11:46–53. http://dx.doi.org/10.1111/j.1468-1293.2009.00741.x.
25. Rose M., Hildebrandt M., Fliege H., Seibold S., Mönnikes H., Klapp B.F. T-cell immune parameters and depression in patients with Crohn's disease. Journal of Clinical Gastroenterology. 2002. 34:40–48. http://dx.doi.org/10.1097/00004836-200201000-00008.
26. Rowland S.M., Lam C.S., Leahy B. Use of the Beck depression inventory-II (BDI-II) with persons with traumatic brain injury: Analysis of factorial structure. Brain Injury. 2005. 19:77–83. http://dx.doi.org/10.1080/02699050410001719988.
27. Ryu K.H., Oh K.J. Effect of depressive mood on identification of emotional facial expression. Korean Journal of the Science of Emotion and Sensibility. 2008. 11:11–21.
28. Scheper H.J., Brand H.S. Oral aspects of Crohn's disease. International Dental Journal. 2002. 52:163–172. http://dx.doi.org/10.1111/j.1875-595X.2002.tb00622.x.
29. Yang S.K., Yun S., Kim J.H., Park J.Y., Kim H.Y., Kim Y.H., et al. Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986-2005: A KASID study. Inflammatory Bowel Diseases. 2008. 14:542–549. http://dx.doi.org/10.1002/ibd.20310.
30. Ye B.D., Jang B.I., Jeen Y.T., Lee K.M., Kim J.S., Yang S.K. Diagnostic guideline of Crohn's disease. The Korean Journal of Gastroenterology. 2009. 53:161–176.
TOOLS
Similar articles