Long‐term course of inflammatory bowel disease after the Great East Japan Earthquake

Miyazawa, Teruko; Shiga, Hisashi; Kinouchi, Yoshitaka; Takahashi, Seiichi; Tominaga, Gen; Takahashi, Hiroki; Takagi, Sho; Obana, Nobuya; Kikuchi, Tatsuya; Omori, Shinya; Sato, Yuichirou; Takahashi, Shūichirō; Umemura, Ken; Endo, Katsuya; Kakuta, Yoichi; Matsuura, Masaki; Kimura, Tsutomu; Kuroha, Masatake; Shimosegawa, Tooru

doi:10.1111/jgh.14286

Cited by 5 publications

(9 citation statements)

References 25 publications

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“…Conversely, in medium-long term (up to 5 years), a significant difference on the slope decrease of hospitalizations for acute and chronic respiratory diseases in the earthquake vs. the neighbor geographical areas. Consistently, also studies investigating the incidence rates of IBD flare-ups after the Great East Japan Earthquake showed an increase in the short follow-up period (after 4 months) and a normalization within the expected rates in the long run (after 24 months) (21,22).…”

Section: Discussionsupporting

confidence: 66%

“…Life-event stress induced by the earthquake was associated with higher relapse rates in UC but not CD patients mediated by changes in diet and family finances worries (21). In contrast, relapse rates decreased significantly at the 2-years follow-up, even though time-to-event analyses showed a significant 2-fold increase of needed additional medical treatment in patients who had experienced the death of family members or friends (22).…”

Section: Introductionmentioning

confidence: 92%

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Influence of the COVID-19 Outbreak on Disease Activity and Quality of Life in Inflammatory Bowel Disease Patients

et al. 2021

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Objective: The present preliminary cross-sectional study aimed to investigate the extent to which health-related quality of life of patients with inflammatory bowel disease (IBD) was influenced by the outbreak of Covid-19 while controlling for disease activity.Methods: Two samples of 195 (recruited before Covid-19 outbreak) and 707 patients (recruited during the Covid-19-related lockdown) were included. Psychological distress (Hospital Anxiety and Depression Scale, HADS), quality of life (Inflammatory Bowel Disease Questionnaire, IBDQ), and somatization (Patient Health Questionnaire, PHQ-12) were concurrently assessed.Results: Patients with active IBD were more prevalently affected by ulcerative colitis (60.2%, η2 = 0.12) and, expectedly, showed higher psychological distress (HADS, d = 0.34) and somatization (PHQ-12, d = 0.39), as well as poorer disease-specific health-related quality of life (effect sizes for the total and subscale IBDQ scores in the large range of d > 0.50). Hierarchical regression models revealed that setting (pre-Covid-19 outbreak vs. during lockdown) (p < 0.001) explained only a small portion (8%) of the IBDQ variance. IBD-related factors (ulcerative colitis and disease activity) and psychological factors (psychological distress and somatization) added a significant amount of 25 and 27%, respectively, to the explained IBDQ variance. The final model predicted 59% of the explained IBDQ variance.Conclusion: Clinical and psychological manifestations seem to be major impairments in IBD patients both before and during the Covid-19 outbreak. Furthermore, the quality of life of IBD patients seem to be more influenced by psychological and somatizing distressing symptoms than the pandemic-related living conditions.

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 92%

Influence of the COVID-19 Outbreak on Disease Activity and Quality of Life in Inflammatory Bowel Disease Patients

et al. 2021

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“…One observational study after a devastating earthquake reported that patients with IBD who had experienced the death of family members or friends were likely to need additional treatments. 28 This study indicated that depression could be a cause of worsening disease activity rather than depression being a result of a poor clinical course. Furthermore, this result indicates that the disease activity of patients with UC who have depressive symptoms could be improved by prompt intervention performed by a psychiatrist, which might ultimately contribute to an improved prognosis.…”

Section: Discussionmentioning

confidence: 82%

“…We have been conducting a prospective questionnaire survey to investigate the causal relationship. One observational study after a devastating earthquake reported that patients with IBD who had experienced the death of family members or friends were likely to need additional treatments 28 . This study indicated that depression could be a cause of worsening disease activity rather than depression being a result of a poor clinical course.…”

Section: Discussionmentioning

confidence: 95%

Depression is associated with increased disease activity in patients with ulcerative colitis: A propensity score‐matched analysis using a nationwide database in Japan

et al. 2022

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Background and Aim The incidence and prevalence of psychiatric disorders are elevated in patients with inflammatory bowel disease (IBD). Whether psychiatric disorders could affect the clinical course of IBD is uncertain and controversial. We aimed to evaluate the impact of psychiatric disorders, particularly depression, on the clinical course of IBD using a nationwide database in Japan. Methods We collected data on admissions with IBD using the Diagnosis Procedure Combination database system introduced in Japan. We divided eligible admissions into IBD with and without depression groups using propensity score matching and compared the rates of surgery, use of molecular targeted drugs and biologics, systemic steroid administrations, and in‐hospital death. We also conducted a logistic regression analysis to identify clinical factors affecting surgery, the use of molecular targeted drugs and biologics, and systemic steroid administrations. Results The rates of surgery, use of two or more molecular targeted drugs, systemic steroid administrations, and in‐hospital deaths in the ulcerative colitis (UC) with depression group were higher than in the UC without depression group. Multivariate analysis of UC showed that depression increased the odds of systemic steroid administrations, use of two or more molecular targeted drugs, and surgery. However, analysis of Crohn's disease showed that only steroid administrations were associated with depression. Conclusion Our study demonstrated an association between a worse clinical course of UC and depression. Although this result indicates that depression might be associated with increased disease activity in patients with UC, the causal relationship is still unclear. Further prospective studies are warranted.

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“…Acute and chronic stress may affect IBD disease activity [7,11,12]. For example, a study showed an increase frequency of disease relapse in IBD patients following the Great East Japan earthquake of March 2011 [13]. However, it is not known how the stress during a pandemic impacts the disease activity.…”

Section: Introductionmentioning

confidence: 99%

A more frequent disease monitorering but no increased disease activity in patients with inflammatory bowel disease during the first year of the SARS-CoV-2 pandemic. A retrospective study

Lindhagen

Karling

2021

Scandinavian Journal of Gastroenterology

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Background and Aims: The SARS-CoV-2 pandemic abruptly switched the healthcare service for patients with inflammatory bowel disease (IBD) towards a telemedicine dominated approach. The aim of this study was to investigate the impact of this switch on monitoring of patients and on disease activity. Material: The pre-pandemic year included 868 patients and the first year of the pandemic included 891 patients. Medical records were retrospectively checked for contacts, changes in medical treatment, performed fecal calprotectin (FC) tests and colonoscopies. Results: The scheduled follow-up visits to a doctor for patients with IBD shifted from mostly face-toface pre-pandemic (from 389 to 118 appointments) to mostly telephone-based during the pandemic (from 13 to 423 appointments). There was a 21.3% increase in mean overall scheduled health contacts (p < .001) and a 20.0% increase for the mean number of FC tests (p < .001) in the year of the pandemic compared to the pre-pandemic year. The proportion of patients who had a surveillance colonoscopy was significant lower in the year of the pandemic compared to the pre-pandemic year (12.7% vs 20.1%; p ¼ .002). There were no difference in the proportion of patients with a median FC > 200 mg/kg (18.2% vs 17.1%; p ¼ .767) and in the proportion of patients who changed their medical treatment (24.7% vs 23.9%; p ¼ .713) in the first year of the pandemic compared to the prepandemic year. Conclusions: The shift towards a telemedicine oriented IBD healthcare service in the first year of the pandemic significantly increased the scheduled contacts, as well as the frequency of FC testing. However, there was a significant decrease in performed surveillance colonoscopies. Between the two periods observed, the patients showed no difference in medical treatment or in disease activity.

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Long‐term course of inflammatory bowel disease after the Great East Japan Earthquake

Abstract: The relapse rates 1 and 2 years after the earthquake significantly decreased. The factors that influenced long-term relapse were different from those that influenced short-term relapse.

Cited by 5 publications

References 25 publications

Influence of the COVID-19 Outbreak on Disease Activity and Quality of Life in Inflammatory Bowel Disease Patients

Influence of the COVID-19 Outbreak on Disease Activity and Quality of Life in Inflammatory Bowel Disease Patients

Depression is associated with increased disease activity in patients with ulcerative colitis: A propensity score‐matched analysis using a nationwide database in Japan

A more frequent disease monitorering but no increased disease activity in patients with inflammatory bowel disease during the first year of the SARS-CoV-2 pandemic. A retrospective study

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