title: Depression subtypes in pediatric inflammatory bowel disease.
abstract: OBJECTIVE
  The association between inflammatory bowel disease (IBD) and depression provides a unique opportunity to understand the relation between systemic inflammation and depressive symptom profiles.
  
  
  METHODS
  Youth (n = 226) ages 9 to 17 years with comorbid IBD and depression underwent psychiatric assessment and evaluation of IBD activity. Latent profile analysis (LPA) identified depressive subgroups based on similar responses to the Children's Depression Rating Scale-Revised. Demographic factors, depression severity, anxiety, IBD activity, inflammatory markers, IBD-related medications, and illness perception were evaluated as predictors of profile membership.
  
  
  RESULTS
  Mean age was 14.3 years; 75% had Crohn disease; 31% were taking systemic corticosteroids. Mean depressive severity was moderate, whereas IBD activity, which reflects inflammation, was mild. LPA identified 3 subgroups: Profile-1 (mild, 75%) had diverse low-grade depressive symptoms and highest quality of life; Profile-2 (somatic, 19%) had severe fatigue, appetite change, anhedonia, decreased motor activity, and depressed mood with concurrent high-dose steroid therapy and the highest IBD activity; and Profile-3 (cognitive, 6%) had the highest rates of self-reported depressive symptoms, ostomy placements, and anxiety with IBD symptoms in the relative absence of inflammation.
  
  
  CONCLUSIONS
  Evidence was found for 3 depression profiles in youth with IBD and depression. Our analyses determined that patients with predominantly somatic or cognitive symptoms of depression comprised 25% of our cohort. These findings may be used to design subgroup-specific interventions for depression in adolescents with IBD and other physical illnesses associated with systemic inflammation.
authors.affiliation: *Department of Pediatric Gastroenterology, Children's Hospital of Pittsburgh †Department of Psychiatry, University of Pittsburgh School of Medicine ‡Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA §Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora ||Department of Psychiatry, Boston Children's Hospital ¶Department of Pediatric Gastroenterology, Boston Children's Hospital, Boston, MA.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Szigethy
authors.forename: Ada O
authors.initials: AO
authors.lastname: Youk
authors.forename: David
authors.initials: D
authors.lastname: Benhayon
authors.forename: Diane L
authors.initials: DL
authors.lastname: Fairclough
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Newara
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Kirshner
authors.forename: Simona I
authors.initials: SI
authors.lastname: Bujoreanu
authors.forename: Christine
authors.initials: C
authors.lastname: Mrakotsky
authors.forename: Athos
authors.initials: A
authors.lastname: Bousvaros
authors.forename: Arvind I
authors.initials: AI
authors.lastname: Srinath
authors.forename: David J
authors.initials: DJ
authors.lastname: Keljo
authors.forename: David J
authors.initials: DJ
authors.lastname: Kupfer
authors.forename: David R
authors.initials: DR
authors.lastname: DeMaso
mesh_terms: D015746:Abdominal Pain; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001007:Anxiety; D002648:Child; D003863:Depression / Q000145:classification*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents