Multi-factor Analysis of Psychological Disorders in IBD Patients
Condition: Inflammatory Bowel Diseases
MeSH terms: Intestinal Diseases; Inflammatory Bowel Diseases; Mental Disorders
Study type: Observational

Summary: 
      Inflammatory bowel disease IBD, including Crohn's disease (CD) and ulcerative colitis (UC),
      is a chronic inflammatory disease of the intestinal tract with unknown etiology. The
      mechanism includes environment, genetics, intestinal microecology and immunity. In recent
      years, the incidence of IBD in Asian countries has continued to rise, and the incidence of CD
      and UC in Guangzhou has reached 1.09/10 million and 2.05/10 million respectively. The patient
      suffers from the disease for a long time, which greatly affects the mentality and the quality
      of life. However, the mentality and quality of life of IBD patients have not received the
      attention they deserve, and research in this area is relatively lacking. The study by Lewis
      et al. found that among IBD patients, up to 1/3 of depression patients and 2/3 of anxiety
      patients were not diagnosed in time. This study conducted an Internet questionnaire survey on
      IBD patients diagnosed in the Department of Gastroenterology, the Second Affiliated Hospital
      of Zhejiang University School of Medicine, to learn about the patients 'mental and
      psychological state, to screen the risk factors of patients'mental and psychological
      diseases, and to understand the impact of mental and psychological factors on the quality of
      life and quality of IBD patients. The impact of the disease provides a scientific basis for
      the optimal treatment of IBD.
    

Detailed description: 
      Patients with IBD self-reported their disease activity using validated patient-based
      measures. For those with CD, the Harvey-Bradshaw Index (HBI) was utilized, and for patients
      with UC, the Patient-based Simple Clinical Colitis Activity Index (P-SSCAI) was employed. An
      HBI score greater than 4 or a P-SSCAI score of 5 or higher was classified as active disease,
      while an HBI score of 4 or lower or a P-SSCAI score below 5 indicated disease remission.

      To assess health-related quality of life (HRQOL), participants completed the Short Health
      Scale (SHS), a 4-item self-management questionnaire validated for use in adult IBD patients.
      Each item corresponds to specific dimensions of HRQOL: symptoms, social function,
      disease-related worry, and general well-being. Responses were graded on a 100-mm visual
      analog scale, with scores ranging from 0 to 100, where higher scores represented worse HRQOL.

      Participants' anxiety and depression levels were evaluated using the Generalized Anxiety
      Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9)20,21. Each scale comprises 7
      and 9 self-assessment items to gauge anxiety and depression, respectively. A score of GAD-7
      ≥10 indicated severe anxiety symptoms, while a score of PHQ-9 ≥ 10 indicated severe
      depression symptoms.

      The Pittsburgh Sleep Quality Index scale (PSQI) was employed to assess sleep quality,
      encompassing subjective sleep quality, latency, duration, efficiency, persistence, use of
      sleep drugs, and daytime dysfunction22. The total scores on this scale range from 0 to 21,
      with higher scores indicating poorer sleep quality.

      Statistical analysis The survey data were collected and analyzed using IBM SPSS statistical
      software (version 25.0, Chicago, Illinois, USA). Quantitative data were expressed as mean and
      standard deviation or inter-quartile range, and group differences were compared using t-tests
      for normally distributed data or the Wilcoxon test for non-normally distributed data.
      Categorical data were presented as frequencies or percentages, and differences in frequencies
      between groups were assessed using the χ2 test or Fisher's exact test. The correlation
      between scores of GAD-7 or PHQ-9 and SHS total scores was examined using simple linear
      regression, and the results were presented with the coefficient R2. To study the independent
      effect of various variables on the quality of life (QOL), multiple regression analysis was
      applied. Initially, correlations between demographic and clinical variables such as age,
      gender, living conditions, disease status, employment, marital status, family history of IBD,
      GAD-7 scores, PHQ-9 scores, and SDS scores were explored using simple regression. Variables
      with a p-value of ≤ 0.05 in the simple regression analyses were then included in the multiple
      regression analysis. Odds ratios (OR), 95% confidence intervals (95% CI), and p-values were
      calculated for each independent variable. For all statistical tests, a two-sided p-value of
      0.05 was considered the threshold for defining the level of significance.
    

Observational model: Other
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Participants were age 18 years or older, able to provide informed consent, and had
        sufficient knowledge to complete written questionnaires and a structured clinical
        interview. Participants were required to have completed their Structured Clinical Interview
        for Diagnostic and Statistical Manual (DSM)-IV-TR Axis I Disorders (SCID) within 4 weeks of
        their enrollment visit date and to meet the DSM-IV criteria for a depression or anxiety
        disorder.
      
Biospecimen description: 
      not needed
    
Keywords: inflammatory bowel disease; psychological disorders