Anxiety Symptoms and Disease Severity in Children and Adolescents With Crohn Disease

Reigada, Laura C.; Hoogendoorn, Claire J.; Walsh, Lindsay C.; Lai, Joanne; Szigethy, Eva; Cohen, Brian D.; Bao, Rong; Isola, Kimberly; Benkov, Keith

doi:10.1097/mpg.0000000000000552

Cited by 40 publications

(46 citation statements)

References 50 publications

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“…16 Both anxiety and depression are increased among patients with IBD compared with other disease states and the general population. 17–19 In addition, anxiety has been associated with worse outcomes among pediatric patients with IBD 20 and increased resource utilization among adult patients with IBD. 21,22 Although the impact of these psychological comorbidities has been evaluated in multiple studies, a majority of patients with UC or CD may not receive adequate psychosocial support in the scheme of their overall treatment for IBD.…”

Section: Discussionmentioning

confidence: 99%

The Burden of Hospital Readmissions among Pediatric Patients with Inflammatory Bowel Disease

Barnes

Kochar

Long

et al. 2017

The Journal of Pediatrics

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Objective To evaluate the burden and predictors of hospital readmissions among pediatric patients with inflammatory bowel disease using the Nationwide Readmissions Database. Study design We performed a retrospective cohort study using 2013 Nationwide Readmissions Database. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify patients <18 years with diagnoses of ulcerative colitis (UC) or Crohn disease (CD). Demographic factors and details of hospitalizations were evaluated using survey procedures in SAS v 9.4 (SAS Institute, Cary, North Carolina). Multivariable logistic regression was used to estimate ORs and 95% CIs of readmission. Results Among 2733 hospitalizations (63% CD, 37% UC), 611 (22%) patients were readmitted within 90 days of the index hospitalization. Readmission resulted in weighted estimates of 11 440 excess days of hospitalization and total charges of over $107 million. For CD, male sex (aOR 1.36, 95% CI 1.03–1.81) and co-existing anxiety or depression (aOR 1.89, 95% CI 1.06–3.40) were associated with increased readmissions, while patients who underwent surgery had decreased readmissions (aOR 0.40, 95% CI 0.24–0.65). In patients with UC, and index admission of >7 days was associated with increased readmissions (aOR 1.69, 95% CI 1.09–2.62). Conclusions Readmission occurs frequently in children with inflammatory bowel disease and is associated with significant cost and resource burdens. Among patients with CD, psychiatric comorbidities such as anxiety and depression are apparent drivers of readmission.

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Section: Discussionmentioning

confidence: 99%

The Burden of Hospital Readmissions among Pediatric Patients with Inflammatory Bowel Disease

Barnes

Kochar

Long

et al. 2017

The Journal of Pediatrics

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“…Although depression and anxiety were not specific targets of intervention, higher prevalence of these psychological problems has been reported in children with IBD as noted in the introduction 18,19 and it was of interest to determine if an intervention to improve stress management and coping might have secondary effects on psychosocial function. Children in both conditions reported significant improvement on psychosocial functioning and depression symptoms with no difference between groups.…”

Section: Discussionmentioning

confidence: 99%

“…7,13-17 Typical of these, recently Reigada et al 18 found that anxiety symptoms were significantly associated with moderate/severe disease activity among children and adolescents with CD. Similarly, Srinath et al 19 found that depression was a significant predictor of abdominal pain in children and adolescents with IBD, perhaps more so in UC than in CD.…”

Section: Introductionmentioning

confidence: 97%

Effects of a Cognitive Behavioral Therapy Intervention Trial to Improve Disease Outcomes in Children with Inflammatory Bowel Disease

Levy

Tilburg

Langer

et al. 2016

Inflammatory Bowel Diseases

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Background Studies testing the efficacy of behavioral interventions to modify psychosocial sequelae of IBD in children are limited. This report presents outcomes through a six month follow up from a large RCT testing the efficacy of a cognitive-behavioral intervention for children with IBD and their parents. Methods 185 children age 8-17 years with a diagnosis of Crohn's (CD) or Ulcerative Colitis (UC) and their parents were randomized to one of two 3-session conditions: 1.) a social learning and cognitive-behavioral therapy condition (SLCBT) or 2.) an education support condition designed to control for time and attention. Results There was a significant overall treatment effect for school absences due to CD or UC (p<.05) at 6 months post-treatment. There was also a significant overall effect post-treatment for child-reported quality of life (p<.05), parent- reported increases in adaptive child coping (p<.001) and reductions in parents’ maladaptive responses to children's symptoms (p<.05). Finally, exploratory analyses indicated that for children with a higher level of flares (2 or more) pre-baseline, those in SLCBT experienced a greater reduction in flares post-treatment. Conclusions This trial suggests that a brief cognitive-behavioral intervention for children with IBD and their parents can result in improved child functioning and quality of life, and for some children may decrease disease activity.

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“…[6][7][8] Moreover, several researchers have reported that youth with IBD may be at risk for anxiety symptoms. 7,13,14 However, not all studies have corroborated the findings of increased risk of internalizing symptoms among youth with IBD. 9 The inconsistencies in findings across studies are likely related to several factors.…”

mentioning

confidence: 87%

“…10,18 Similarly, youths with moderate-to-severe disease activity have been shown to be at risk for higher levels of anxiety symptoms relative to those with no or mild disease activity. 14 This study aimed to expand the existing research by examining rates of depressive symptoms, anxiety symptoms, and overall internalizing symptomatology in a relatively large, multisite sample of youth with IBD. Of note, we focused on a sample of youth with established diagnoses who were on oral medications and who had low levels of disease activity.…”

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confidence: 99%

Feeling Fine

Walter

Kahn

Noe

et al. 2016

Inflammatory Bowel Diseases

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Anxiety Symptoms and Disease Severity in Children and Adolescents With Crohn Disease

Abstract: Implementing a brief anxiety screen in tertiary pediatric settings may be one approach to identify young patients with CD in distress. Health care providers should consider periodic assessment of school anxiety among youth with CD.

Cited by 40 publications

References 50 publications

The Burden of Hospital Readmissions among Pediatric Patients with Inflammatory Bowel Disease

The Burden of Hospital Readmissions among Pediatric Patients with Inflammatory Bowel Disease

Effects of a Cognitive Behavioral Therapy Intervention Trial to Improve Disease Outcomes in Children with Inflammatory Bowel Disease

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