Using the Children's Depression Inventory in youth with inflammatory bowel disease: support for a physical illness-related factor

Thompson, Rachel D.; Craig, Anna E.; Mrakotsky, Christine; Bousvaros, Athos; DeMaso, David R.; Szigethy, Eva

doi:10.1016/j.comppsych.2012.04.006

Cited by 25 publications

(27 citation statements)

References 31 publications

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“…Both are brief, self-report measures that can be administered, scored, and reviewed with the family to initiate discussion if elevations are identified. However, these measures should be supplemented with a clinical interview, as recent data suggest that CDI scores may be inflated because of physical illness symptoms related to IBD [47]. Early identification of symptoms at the parent and/or patient level that negatively impact IBD management is critical given that psychosocial impairment (i.e.…”

Section: Discussionmentioning

confidence: 99%

Parenting stress predicts depressive symptoms in adolescents with inflammatory bowel disease

Guilfoyle

Gray²,

Herzer-Maddux³

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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Objectives Adolescents with inflammatory bowel disease (IBD) are at an increased risk for depression and poor IBD management. Although depression and family factors have been associated in cross-sectional analyses, their casual association over time has not been studied. The primary objective of this study was to assess the temporal association between parenting stress and adolescent depressive symptoms in IBD. Methods Along with a primary parent, adolescents [Mage(years) = 15.5 ± 1.4] with a confirmed diagnosis of Crohn's disease or ulcerative colitis and prescribed a treatment regimen of a 5-ASA medication and/or 6-MP/azathioprine were recruited from routine gastroenterology clinic visits at two pediatric medical centers. The current study was nested in a larger IBD self-management trial. Adolescents completed the Children's Depression Inventory. Parents completed a sociodemographic questionnaire and the Pediatric Inventory for Parents. Gastroenterologists provided disease severity assessments on the basis of the clinic appointment corresponding to the study visit or the most recent clinic appointment. Questionnaires were readministered ∼ 6 months after the initial visit. Results Participants include 93 families at baseline and 65 at follow-up (69.8% retention; N = 65). A cross-lagged panel analysis was used to detect causal directionality and change in adolescent depression and parenting stress over 6 months. Baseline parenting stress accounted for a significant amount of the variance in depressive symptoms at follow-up [R-change = 0.03, F(1,58) = 35.6, P < 0.05]. Conclusion Parenting stress impacts adolescent depressive symptoms in IBD. Identification of parenting stress and adolescent depression should occur early and possibly in the context of routine clinic visits.

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Section: Discussionmentioning

confidence: 99%

Parenting stress predicts depressive symptoms in adolescents with inflammatory bowel disease

Guilfoyle

Gray²,

Herzer-Maddux³

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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“…(9) Depressive phenotypes of individual patients can be quite heterogeneous; however, distinct clusters of depressive symptoms have been identified. (10, 11) In patients with IBD, such depressive subtypes can have many different etiological underpinnings,(12) In a recent study, we conducted latent profile analysis to evaluate the relationship between systemic inflammation and depressive symptom profiles in 226 depressed youth with IBD. (13) Three distinct depressive profiles were identified: (1) youth with diverse milder depressive symptoms in the relative absence of systemic inflammation (75%); (2) youth with (13) high levels of somatic depressive symptoms in the presence of elevated inflammation (19%); and (3) youth with high levels of cognitive despair, including suicidal ideation, with relatively low inflammation (6%).…”

Section: Introductionmentioning

confidence: 99%

Pediatric inflammatory bowel disease and depression

Keethy

Mrakotsky

Szigethy

2014

Current Opinion in Pediatrics

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Purpose of review Depression in pediatric inflammatory bowel disease (IBD) is increasingly recognized to be a heterogeneous condition with diverse underlying predisposing and precipitating factors. Although there is a growing awareness regarding the benefits of integrating behavioral health into medical care, the way psychiatric treatments can best target different aspects of depression and related dysfunction has not been systematically explored. Recent findings This review discusses neurobiological risk factors for depression in IBD including inflammation, associated anti-inflammatory treatment with corticosteroids, pain, and sleep disturbance, as well as psychosocial factors including reactions to illness, illness perception, and disease and environmental stressors with emphasis of how these factors can influence treatment decisions. Empirically-supported psychosocial and psychopharmacological interventions are discussed within this context. Summary Understanding the diverse pathways that can lead to depression in youth with IBD can lead to the development of more targeted interventions and better integration of psychosocial care into the medical treatment of IBD.

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“…15 Moreover, measures vary with respect to their inclusion of somatic-focused items (e.g., "I often feel tired"). Because somatic items may reflect IBD symptomatology rather than psychiatric symptoms, 16 measures that include a large number of somatic items (e.g., Children's Depression Inventory) may overestimate prevalence. Finally, certain characteristics of the samples used in previous research may limit generalizability of findings to the full pediatric IBD.…”

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confidence: 98%