Assessment of anxiety and depression in IBD adolescents

Abstract

Inflammatory Bowel Disease (IBD) is a chronic disease, with typical pediatric onset. Due to its unpredictable course and “embarrassing” symptoms, IBD can have a significant impact on cognitive and psychosocial development. Further, the majority of existing studies demonstrate that there are high rates of psychiatric disorders, most commonly anxiety and depression, among IBD youth (Burke, Meyer, Kocoshis et al., 1989; Engstrom, 1992; Engstrom & Lindquist, 1991; Szajnberg, Krall, Davis, Treem, & Hyams, 1993; Szigethy et al., 2004). Prevalence rates range from 25 to 60 percent, with majority of studies reporting near 50%, and these rates may be higher compared to other chronically ill adolescents. To complicate matters, anxiety and depression are associated with significant long-term disabilities (Ialongo, Edelsohn, Werthamer-Larsson, Crockett, & Kellam, 1994, 1995), and may impact disease management and healthcare utilization (Mittermaier et al., 2004). To date, scarce research has investigated these factors, and existing research has significant methodological limitations, making this a top 5 area for research according to Crohn's and Colitis Foundation of America (2006). The present study will provide information regarding the nature of anxiety and depression (i.e., disease specific and general) for youth, ages 12-17, with IBD, as well as describe disease management, healthcare utilization, and general and social functioning. Data collection has been initiated at two New York City pediatric gastroenterology medical clinics and will include information regarding demographics, IBD illness severity, disease management, medical usage, anxiety and depressive symptoms, and psychosocial functioning across multiple relevant functional domains. Measures were also included to assess parental anxiety and depression, physician ratings of family's use of services, and parent's involvement in disease management and the child's treatment. Analyses will examine the relationship of psychopathology (child and parent) with disease management, medical usage, and quality of life. Results will be discussed in terms of their implications for treating anxiety and depression in adolescents with this chronic illness and in designing and implementing interventions for this population.