본문 바로가기
KERD
논문KCI 등재

Unmet Psychosocial Needs of Patients Newly Diagnosed with Ulcerative Colitis: Results from the Nationwide Prospective Cohort Study in Korea

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

초록

Background/Aims: Limited data are available regarding psychosocial distress at the time of diagnosis of ulcerative colitis (UC). We investigated the psychosocial burden and factors related to poor health-related quality of life (HRQL) among patients newly diagnosed with moderate-to-severe UC who were affiliated with the nationwide prospective cohort study. Methods: Within the first 4 weeks of UC diagnosis, all patients were assessed using the Hospital Anxiety and Depression Scale (HADS), Work Productivity and Activity Impairment questionnaire, Inflammatory Bowel Disease Questionnaire (IBDQ), and 12-Item Short Form (SF-12) health survey. A multiple linear regression model was used to identify factors associated with HRQL. Results: Between August 2014 and February 2017, 355 patients completed questionnaires. Significant mood disorders requiring psychological interventions, defined by a HADS score ≥11, were identified in 16.7% (anxiety) and 20.6% (depression) of patients. Patients with severe disease were more likely to have presenteeism, loss of work productivity, and activity loss than those with moderate disease (all p<0.05). Significant mood disorders had the strongest negative relationship with total IBDQ score, which indicates disease-specific HRQL (β coefficient: –22.1 for depression and –40.0 for anxiety, p<0.001). The scores of all SF-12 dimensions, which indicate general HRQL, were remarkably decreased in the study population compared indirectly with previously reported scores in the general population. The Mayo score, C-reactive protein level, and white blood cell count showed significant negative associations with the IBDQ score (p<0.05). Conclusions: Psychosocial screening and timely interventions should be incorporated into the initial care of patients newly diagnosed with UC.

Abstract

Background/Aims: Limited data are available regarding psychosocial distress at the time of diagnosis of ulcerative colitis (UC). We investigated the psychosocial burden and factors related to poor health-related quality of life (HRQL) among patients newly diagnosed with moderate-to-severe UC who were affiliated with the nationwide prospective cohort study. Methods: Within the first 4 weeks of UC diagnosis, all patients were assessed using the Hospital Anxiety and Depression Scale (HADS), Work Productivity and Activity Impairment questionnaire, Inflammatory Bowel Disease Questionnaire (IBDQ), and 12-Item Short Form (SF-12) health survey. A multiple linear regression model was used to identify factors associated with HRQL. Results: Between August 2014 and February 2017, 355 patients completed questionnaires. Significant mood disorders requiring psychological interventions, defined by a HADS score ≥11, were identified in 16.7% (anxiety) and 20.6% (depression) of patients. Patients with severe disease were more likely to have presenteeism, loss of work productivity, and activity loss than those with moderate disease (all p<0.05). Significant mood disorders had the strongest negative relationship with total IBDQ score, which indicates disease-specific HRQL (β coefficient: –22.1 for depression and –40.0 for anxiety, p<0.001). The scores of all SF-12 dimensions, which indicate general HRQL, were remarkably decreased in the study population compared indirectly with previously reported scores in the general population. The Mayo score, C-reactive protein level, and white blood cell count showed significant negative associations with the IBDQ score (p<0.05). Conclusions: Psychosocial screening and timely interventions should be incorporated into the initial care of patients newly diagnosed with UC.

참고문헌 (49)

  1. Irvine EJ, "Quality of life of patients with ulcerative colitis : past, present, and future", Inflamm Bowel Dis, 14, pp.554~565 (2008)
  2. Yarlas A, "Burden of ulcerative colitis on functioning and well-being : a systematic literature review of the SF-36® health survey", J Crohns Colitis, 12, pp.600~609 (2018)
  3. Williet N, "Patient-reported outcomes as primary end points in clinical trials of inflammatory bowel disease", Clin Gastroenterol Hepatol, 12, pp.1246~1256 (2014)
  4. Feagan BG, "Effects of vedolizumab on health-related quality of life in patients with ulcerative colitis : results from the randomised GEMINI 1 trial", Aliment Pharmacol Ther, 45, pp.264~275 (2017)
  5. Han SW, "Predictors of quality of life in ulcerative colitis : the importance of symptoms and illness representations", Inflamm Bowel Dis, 11, pp.24~34 (2005)
  6. Hoivik ML, "Health-related quality of life in patients with ulcerative colitis after a 10-year disease course : results from the IBSEN study", Inflamm Bowel Dis, 18, pp.1540~1549 (2012)
  7. Zheng K, "Health-related quality of life in Chinese patients with mild and moderately active ulcerative colitis", PLoS One, 10, pp.e0124211~ (2015)
  8. Gibson PR, "Relationship between disease severity and quality of life and assessment of health care utilization and cost for ulcerative colitis in Australia : a crosssectional, observational study", J Crohns Colitis, 8, pp.598~606 (2014)
  9. Ghosh S, "Impact of inflammatory bowel disease on quality of life : results of the European Federation of Crohn's and Ulcerative Colitis Associations(EFCCA)patient survey", J Crohns Colitis, 1, pp.10~20 (2007)
  10. Walker JR, "The Manitoba IBD cohort study : a population-based study of the prevalence of lifetime and 12-month anxiety and mood disorders", Am J Gastroenterol, 103, pp.1989~1997 (2008)
  11. Iglesias-Rey M, "Psychological factors are associated with changes in the healthrelated quality of life in inflammatory bowel disease", Inflamm Bowel Dis, 20, pp.92~102 (2014)
  12. Bernstein CN, "Psychological stress and depression : risk factors for IBD", Dig Dis, 34, pp.58~63 (2016)
  13. Viganò CA, "Alexithymia and psychopathology in patients suffering from inflammatory bowel disease : arising differences and correlations to tailoring therapeutic strategies", Front Psychiatry, 9, pp.324~ (2018)
  14. Cohen BL, "Fatigue is highly associated with poor health-related quality of life, disability and depression in newly-diagnosed patients with inflammatory bowel disease, independent of disease activity", Aliment Pharmacol Ther, 39, pp.811~822 (2014)
  15. 윤진영, "Disability due to Inflammatory Bowel Disease Is Correlated with Drug Compliance, Disease Activity, and Quality of Life", Gut and Liver, 11(3), pp.370~376 (2017), 거트앤리버 소화기연관학회협의회
  16. 김영선, "Impact of inflammatory bowel disease on daily life: an online survey by the Korean Association for the Study of Intestinal Diseases", Intestinal research, 15(3), pp.338~344 (2017), 대한장연구학회
  17. Ng SC, "Epidemiology of inflammatory bowel disease : focus on Asia", Best Pract Res Clin Gastroenterol, 28, pp.363~372 (2014)
  18. Kim HJ, "Incidence and natural course of inflammatory bowel disease in Korea, 2006-2012 : a nationwide population-based study", Inflamm Bowel Dis, 21, pp.623~630 (2015)
  19. Kim JW, "Trends in health-care costs and utilization for inflammatory bowel disease from 2010 to 2014 in Korea : a nationwide population-based study", J Gastroenterol Hepatol, 33, pp.847~854 (2018)
  20. Kim ES, "Predictive factors of impaired quality of life in Korean patients with inactive inflammatory bowel disease : association with functional gastrointestinal disorders and mood disorders", J Clin Gastroenterol, 47, pp.e38~e44 (2013)
  21. Ueno F, "Impact of inflammatory bowel disease on Japanese patients' quality of life : results of a patient questionnaire survey", J Gastroenterol, 52, pp.555~567 (2017)
  22. Chang Kyun Lee, "A new opportunity for innovative inflammatory bowel disease research: the moderate-to-severe ulcerative colitis in Korea (MOSAIK) cohort study", Intestinal research, 17(1), pp.1~5 (2019), 대한장연구학회[DOI]
  23. Solberg IC, "Clinical course during the first 10 years of ulcerative colitis : results from a populationbased inception cohort(IBSEN Study)", Scand J Gastroenterol, 44, pp.431~440 (2009)
  24. Schroeder KW, "Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis : a randomized study", N Engl J Med, 317, pp.1625~1629 (1987)
  25. D'Haens G, "A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis", Gastroenterology, 132, pp.763~786 (2007)
  26. Zigmond AS, "The hospital anxiety and depression scale", Acta Psychiatr Scand, 67, pp.361~370 (1983)
  27. Oh SM, "A Study on the standardization of the hospital anxiety and depression scale for Koreans : a comparison of normal, depressed and anxious groups", J Korean Neuropsychiatr Assoc, 38, pp.289~296 (1999)
  28. Bernstein CN, "The validity and reliability of screening measures for depression and anxiety disorders in inflammatory bowel disease", Inflamm Bowel Dis, 24, pp.1867~1875 (2018)
  29. Reilly MC, "The validity and reproducibility of a work productivity and activity impairment instrument", Pharmacoeconomics, 4, pp.353~365 (1993)
  30. Pallis AG, "The inflammatory bowel disease questionnaire : a review of its national validation studies", Inflamm Bowel Dis, 10, pp.261~269 (2004)
  31. Guyatt G, "A new measure of health status for clinical trials in inflammatory bowel disease", Gastroenterology, 96, pp.804~810 (1989)
  32. Irvine EJ, "Quality of life : a valid and reliable measure of therapeutic efficacy in the treatment of inflammatory bowel disease. Canadian Crohn's Relapse Prevention Trial Study Group", Gastroenterology, 106, pp.287~296 (1994)
  33. Ware J Jr, "A 12-Item Short-Form Health Survey : construction of scales and preliminary tests of reliability and validity", Med Care, 34, pp.220~233 (1996)
  34. Maruish ME, "A guide to the integration of certified Short Form survey scoring and data quality evaluation capabilities", Quality Metric Incorporated, ~ (2009)
  35. Kim SH, "Assessment of psychometric properties of the Korean SF-12 v2 in the general population", BMC Public Health, 14, pp.1086~ (2014)
  36. Mikocka-Walus A, "Controversies revisited : a systematic review of the comorbidity of depression and anxiety with inflammatory bowel diseases", Inflamm Bowel Dis, 22, pp.752~762 (2016)
  37. Williet N, "Patient-reported outcomes in a French nationwide survey of inflammatory bowel disease patients", J Crohns Colitis, 11, pp.165~174 (2017)
  38. Goodhand JR, "Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease", Aliment Pharmacol Ther, 38, pp.1097~1108 (2013)
  39. Calloway A, "Depressive symptoms predict anti-tumor necrosis factor therapy noncompliance in patients with inflammatory bowel disease", Dig Dis Sci, 62, pp.3563~3567 (2017)
  40. Bennebroek Evertsz' F, "The effectiveness of cognitive behavioral therapy on the quality of life of patients with inflammatory bowel disease : multi-center design and study protocol(KL!C-study)", BMC Psychiatry, 12, pp.227~ (2012)
  41. Regueiro MD, "The inflammatory bowel disease specialty medical home : a new model of patient-centered care", Inflamm Bowel Dis, 22, pp.1971~1980 (2016)
  42. Lee CK, "Multidisciplinary team-based approaches to IBD management : how might"one-stop shopping"work for complex IBD care", Am J Gastroenterol, 112, pp.825~827 (2017)
  43. Siegel CA, "Development of an index to define overall disease severity in IBD", Gut, 67, pp.244~254 (2018)
  44. Huppertz-Hauss G, "Health-related quality of life in patients with inflammatory bowel disease 20 years after diagnosis : results from the IBSEN Study", Inflamm Bowel Dis, 22, pp.1679~1687 (2016)
  45. Lee CK, "A multidisciplinary approach to biopsychosocial care for adults with inflammatory bowel disease : a pilot study", Inflamm Bowel Dis, 24, pp.2550~2554 (2018)
  46. Szigethy EM, "White paper AGA : the impact of mental and psychosocial factors on the care of patients with inflammatory bowel disease", Clin Gastroenterol Hepatol, 15, pp.986~997 (2017)
  47. Keefer L, "Best practice update : incorporating psychogastroenterology into management of digestive disorders", Gastroenterology, 154, pp.1249~1257 (2018)
  48. Vavricka SR, "Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease", Inflamm Bowel Dis, 18, pp.496~505 (2012)

관련 논문AI추천

Anxiety and Depression Are Associated with Poor Long-term Quality of Life in Moderate-to-Severe Ulcerative Colitis: Results of a 3-Year Longitudinal Study of the MOSAIK CohortChoi Chang Hwan, Jang Byung Ik, Jung Eun Suk, Jung Sung-Ae, Kim Yoon Jae, Kim Youngdoe, Koo Ja Seol, Lee Chang Kyun, Lee Kang-Moon, Oh Shin Ju, Seo Geom Seog, Shin Sung Jae, Song Geun Am거트앤리버 소화기연관학회협의회 · Gut and Liver2025 · 제19권 제2호Factors Associated with Anxiety and Depression in Korean Patients with Inactive Inflammatory Bowel Disease박동일, 손정일, 정윤숙, Jung Ho Park, Jung In Lee, Kyu Yong Choi, Min Chul Kim, Young Seok Song거트앤리버 소화기연관학회협의회 · Gut and Liver2016 · 제10권 제3호Quality of Life in Newly Diagnosed Moderate-to-Severe Ulcerative Colitis: Changes in the MOSAIK Cohort Over 1 Year이준, 김현수, 이유진, 진윤태, 홍성노, Jo Ik Hyun, Kim Dae Bum, Kim Ji Won, Kim Joo Sung, Kim Tae-Oh, Kim Youngdoe, Lee Kang-Moon, Park Dong Il, Park Jae Jun거트앤리버 소화기연관학회협의회 · Gut and Liver2022 · 제16권 제3호Depression, Anxiety, Related Risk Factors and Cognitive Distortion in Korean Patients with Inflammatory Bowel DiseaseKang Won Sub, Kim Hyo Jong, Kim Jong Woo, Lee Chang Kyun, Oh Chi Hyuk, Song Jun Ho대한신경정신의학회 · PSYCHIATRY INVESTIGATION2020 · 제17권 제11호Development and Assessment of a Novel Ulcerative Colitis–Specific Quality of Life Questionnaire: A Prospective, Multi-Institutional Study김세현, 김영호, 김주성, 남정모, 박동일, 박지혜, 예병덕, 장현수, 진윤태, 천재희연세대학교의과대학 · Yonsei Medical Journal2024 · 제65권 제11호Disability due to Inflammatory Bowel Disease Is Correlated with Drug Compliance, Disease Activity, and Quality of Life박동일, 박상형, 신정은, 윤진영, 차재명거트앤리버 소화기연관학회협의회 · Gut and Liver2017 · 제11권 제3호

이 간행물의 다른 논문 (17건)