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在IBD中抑郁,炎症和自我报告的疾病活动之间的关系及其对医疗保健使用的影响
Natasha Seaton1, Vari Wileman1, Christine Norton2
1Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th Floor Bermondsey Wing Guy's Campus, London Bridge, SE1 9RT, London, UK.
BMC gastroenterology
|March 6, 2025
概括
炎症性肠病 (IBD) 中的抑郁症与自我报告的疾病活动有关,而不是客观的炎症. 与IBD管理一起解决抑郁症可以改善患者的治疗结果并降低医疗保健成本.
科学领域:
- 胃肠病学 胃肠病学
- 精神病学是一个精神病学.
- 卫生经济学 卫生经济学
背景情况:
- 抑郁症在炎症性肠病 (IBD) 患者中很普遍,结果越来越糟糕.
- 现有的研究往往缺乏强大的控制,适当的样本大小,或依赖主观的疾病活动指标.
- 虽然自我报告的疾病活动 (SRDA) 和抑郁与医疗保健使用相关,但客观炎症的作用未得到充分研究.
研究的目的:
- 在IBD患者中调查抑郁症,SRDA和客观肠道炎症 (便calprotectin - FCP) 之间的关系.
- 确定SRDA,炎症和抑郁症对医疗保健利用和经济影响的影响.
主要方法:
- 从随机对照试验的基线对599名IBD患者的横截面分析.
- 使用多个线性回归来评估与SRDA (IBD-Control) 和FCP相关的抑郁症 (PHQ-9).
- 该研究还研究了这些变量对医疗保健使用和生产率的影响.
主要成果:
- 抑郁症是SRDA (β = -0.82) 显著预测的,但不是FCP.
- SRDA和FCP只显示了一个微弱的关联 (r = -0.16).
- 抑郁症独立预测了更多的初级保健访问,IBD二级保健,A&E出席率和生产力下降.
结论:
- 在IBD中,抑郁主要与自我感知的疾病活动有关,而不是像FCP这样的客观炎症标志物.
- 抑郁症独立地导致医疗保健利用率增加和经济负担增加.
- 将抑郁症评估和治疗纳入常规IBD护理中,可以提高患者的福祉,降低医疗保健支出.
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