title: Perianal disease is associated with psychiatric co-morbidity in Crohn's disease in remission.
abstract: OBJECTIVE
  Crohn's disease is a life-long inflammatory disease which can impair quality of life, in particular in patients with psychiatric co-morbidities such as depression and anxiety. The aim of this prospective cohort study was to assess the prevalence of depression and anxiety and related risk factors in patients with quiescent Crohn's disease.
  
  
  METHODS
  A consecutive series of adult patients with confirmed diagnosis of Crohn's disease, in clinical remission, were included and investigated during ambulatory visits using a standard questionnaire assessing demographic and clinical features of the disease. Within 1 month after the ambulatory visit, all patients were interviewed by phone to assess the presence of psychiatric disorders using standardized questionnaires. The questionnaire assessed the development of psychiatric disorders after the diagnosis of Crohn's disease, the use of antidepressant or antianxiety therapy and current anxiety or depression by means of the Hospital Anxiety and Depression Scale.
  
  
  RESULTS
  One hundred and ninety-five patients were included. Seventy-two (36.9 %) patients showed anxiety and/or depression symptoms, 46 (23.6 %) patients showed anxiety symptoms, 6 (3.1 %) patients showed depression symptoms and 20 (10.3 %) patients showed both symptoms. Forty-eight of these patients (58 %) were without any antidepressive or antianxiety treatment. Anxiety with or without depression was significantly correlated with female sex (p = 0.017), history of perianal disease (p = 0.003) and perianal surgery (p = 0.042).
  
  
  CONCLUSIONS
  Anxiety is a frequent, often untreated, condition in patient affected by Crohn's disease in clinical remission. Female sex, history of perianal disease and perianal surgery are major risk factors for anxiety.
authors.affiliation: Gastroenterology Unit, Department of Biomedical and Clinical Sciences, L. Sacco University Hospital, Via G.B. Grassi 74, 20157, Milan, Italy, giovanni.maconi@unimi.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Maconi
authors.forename: Daniele
authors.initials: D
authors.lastname: Gridavilla
authors.forename: Caterina
authors.initials: C
authors.lastname: Viganò
authors.forename: Roberta
authors.initials: R
authors.lastname: Sciurti
authors.forename: Anil K
authors.initials: AK
authors.lastname: Asthana
authors.forename: Federica
authors.initials: F
authors.lastname: Furfaro
authors.forename: Federica
authors.initials: F
authors.lastname: Re
authors.forename: Sandro
authors.initials: S
authors.lastname: Ardizzone
authors.forename: Gabriella
authors.initials: G
authors.lastname: Ba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy / Q000453:epidemiology*; D015897:Comorbidity; D003424:Crohn Disease / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012003:Rectal Fistula / Q000150:complications / Q000523:psychology; D012074:Remission Induction; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents