title: The influence of depression on quality of life in patients with inflammatory bowel disease.
abstract: BACKGROUND
  Inflammatory bowel disease is a chronic inflammatory disorder of the gastrointestinal tract that significantly impacts the health-related quality of life (HR-QOL). A decreased HR-QOL has been demonstrated in patients with active disease compared with patients in remission. In this cross-sectional study, we examined the role of depression and disease activity as independent factors in predicting patient's HR-QOL.
  
  
  METHODS
  Hundred and five patients with either Crohn's disease (CD) or ulcerative colitis (UC) were enrolled. Disease activity was evaluated using Crohn's Disease Activity Index or Seo's Activity Index. Depressive symptoms were evaluated using Beck's Depression Inventory-II and Beck's Depression Inventory for Primary Care (BDI-PC). HR-QOL was evaluated using the Short Inflammatory Bowel Disease Questionnaire. Simple and multiple regressions were performed on quality of life score with demographic and clinical variables as predictors.
  
  
  RESULTS
  The prevalence of depression in our study population is 25%. In patients with both CD and UC, depression is the most significant predictor to a poor HR-QOL (in CD, P = 8.22 × 10; in UC, P = 2.02 × 10). HR-QOL is weakly affected by disease activity (in CD, P = 0.110; in UC, P = 0.00492). In CD, biological use displays positive effect on HR-QOL (P = 0.00780). In total, the proportion of variance explained by all predictors is 61% for CD and 53% for UC, whereas the depression alone explains 44% and 36%.
  
  
  CONCLUSIONS
  Our study demonstrates the importance of depression toward the quality of life in patients with inflammatory bowel disease. The diagnosis of depression should be actively sought out and treated in outpatient inflammatory bowel disease practices.
authors.affiliation: Keck Biotechnology Laboratory, Yale University School of Medicine, New Haven, Connecticut, USA. clarence.k.zhang@yale.edu
authors.forename: Clarence K
authors.initials: CK
authors.lastname: Zhang
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hewett
authors.forename: Jason
authors.initials: J
authors.lastname: Hemming
authors.forename: Taneisha
authors.initials: T
authors.lastname: Grant
authors.forename: Hongyu
authors.initials: H
authors.lastname: Zhao
authors.forename: Clara
authors.initials: C
authors.lastname: Abraham
authors.forename: Ioannis
authors.initials: I
authors.lastname: Oikonomou
authors.forename: Meera
authors.initials: M
authors.lastname: Kanakia
authors.forename: Judy H
authors.initials: JH
authors.lastname: Cho
authors.forename: Deborah D
authors.initials: DD
authors.lastname: Proctor
mesh_terms: D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications* / Q000523:psychology; D003424:Crohn Disease / Q000150:complications* / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult