Psychological distress in Brazilian Crohn's disease patients: screening, prevalence, and risk factors.
BACKGROUND
Psychological disturbances are frequent in Crohn's disease (CD) patients. However, epidemiological studies of non-western CD populations are limited and may be confounded by genetic and disease-related influences. The aim of this study was to assess the prevalence and risk factors for depression and symptoms of anxiety in Brazilian patients with CD.


METHODS
In this cross-sectional study, 110 CD patients and 110 control subjects with erosive esophagitis were assessed for depression and anxiety symptoms using the Beck Depression Inventory and the Hospital Anxiety and Depression Scale.


RESULTS
The Crohn's and control groups were similar with regard to socio-demographic data. Compared with the controls, the CD patients had a significantly higher prevalence of depressed mood (25.4% vs. 8.2%, P=0.003). There was no significant difference in the prevalence of anxiety between CD subjects (33.6%) and controls (22.7%). Depressed mood rates were higher among those who had active disease and greater CDAI scores (OR: 3.4, 95%CI 1.1-10.8). Family history of depression (OR: 5.3, 95%CI: 2.7-15.1) was related to the co-occurrence of anxiety symptoms.


CONCLUSIONS
In CD patients, depression and anxiety are highly concurrent conditions. Disease activity was strongly associated with depressed mood, while a family history of depression was related to anxiety. Screening for depression and anxiety should be carried out routinely as part of quality of care improvement in CD individuals.
Brandi
Maria Tereza
MT
Division of Gastroenterology and Psychiatry, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Minas Gerais, Brazil, Brazil.
Ribeiro
Mário Sergio
MS
Chebli
Liliana Andrade
LA
Franco
Márcio Bousada
MB
Pinto
André Luiz
AL
Gaburri
Pedro Duarte
PD
Zanini
Alexandre
A
Chebli
Julio Maria
JM
D000293:Adolescent; D000328:Adult; D044467:American Indian or Alaska Native / Q000523:psychology*; D001007:Anxiety / Q000150:complications / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D003710:Demography; D003863:Depression / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult