title: Treatment adherence in adolescents with inflammatory bowel disease: the collective impact of barriers to adherence and anxiety/depressive symptoms.
abstract: OBJECTIVE
  Knowledge of factors impacting adolescents' ability to adhere to their inflammatory bowel disease (IBD) regimen is limited. The current study examines the collective impact of barriers to adherence and anxiety/depressive symptoms on adolescent adherence to the IBD regimen.
  
  
  METHODS
  Adolescents (n = 79) completed measures of barriers to adherence, adherence, and anxiety/depressive symptoms at one of two specialty pediatric IBD clinics.
  
  
  RESULTS
  Most adolescents reported barriers to adherence and 1 in 8 reported borderline or clinically elevated levels of anxiety/depressive symptoms. Anxiety/depressive symptoms moderated the relationship between barriers to adherence and adherence. Post hoc probing revealed a significant, additive effect of higher anxiety/depressive symptoms in the barriers-adherence relationship, with adherence significantly lower among adolescents with higher barriers and higher anxiety/depressive symptoms.
  
  
  CONCLUSIONS
  In order to optimize adherence in adolescents, interventions should target not only barriers to adherence but also any anxiety/depressive symptoms that may negatively impact efforts to adhere to recommended treatment.
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Wendy N
authors.initials: WN
authors.lastname: Gray
authors.forename: Lee A
authors.initials: LA
authors.lastname: Denson
authors.forename: Robert N
authors.initials: RN
authors.lastname: Baldassano
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Hommel
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001007:Anxiety / Q000523:psychology*; D057189:Checklist; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000523:psychology; D003424:Crohn Disease / Q000188:drug therapy / Q000523:psychology; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000523:psychology*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D012720:Severity of Illness Index
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