Míra deprese a úzkosti u pacientů s idiopatickými střevními záněty

Abstract

Inflammatory Bowel Disease (IBD), which primarily includes Crohn’s disease (CD) and ulcerative colitis (UC), is a group of chronic diseases affecting the gastrointes‑ tinal tract. In terms of the severity of clinical manifestations of the disease, the severity of treatment, and the overall significant disruption of life, patients may also experience psychological problems. In this context, depression and anxiety appear to be the most common psychopathological co-morbidity in IBD patients. Symptoms of depression or anxiety may lead to intensification of clinical symptoms, general worsening of the course of the disease, or contribute to the relapse of the disease. The primary aim of the research was to map the level of depression and anxiety in adult IBD patients in the Czech Republic. The secondary aim of the research was to describe the relationship between anxiety/ depression and selected clinical and demographic factors. A total of 213 adult IBD patients were admitted to the questionnaire through IBD centres and patient organizations. The data-collection methods were Beck’s Depression Inventory II., Beck’s Anxiety Inventory, and questionnaire for clinical/demographic variables. The results have found that patients included in the research have had a mild level of depression and anxiety. For the secondary aim of the research – data was analysed using univariate analysis, from which significant variables were subsequently included in multiple regression analysis. In univariate analysis, gender (p = 0,02), disease activity (p < 0,001), age (p < 0,01) and type of treatment (p = 0, 04) had a significant relationship to depression. Whereas gender (p = 0,04), disease activity (p < 0,001) and type of treatment (p = 0,04) had a significant relationship to anxi‑ ety. Multiple regression results showed that disease activity (p < 0,001) is among the most important predictors of higher level of depression (β = 0,36) and anxiety (β = 0,20). Multi‑ ple regression has also found age (β = - 0,14; p = 0,03) as a significant predictor for a lower level of depression. Medication with corticosteroids (β = 0,22; p=0,03) has been found as a significant predictor for a higher level of anxiety. The obtained overall results of the re‑ search are comparable to the foreign research’s findings. One of the surprising results was no difference between CD and UC patients in the level of depression or anxiety. The differ‑ ence between individual diseases can be influenced by the activity itself, where foreign researchers have not found any difference between UC and CD patients after controlling for the activity of the disease. The research has some limitations that need to be mentioned. The research sample included mostly female patients, most of the patients underwent biological treatment, thus they were probably patients with a more complicated course of the disease. A significant representation of women might be caused by the fact that women tend to be more involved in support groups or they are more willing to talk about disease-related problems. When measuring depression and anxiety, some issues may have been overestimated as some of them focused on the somatic manifestations of depression or anxiety, thus affected by the current state of the disease. Psychological problems should be considered in general treatment in IBD, with regard to the possible negative impact on disease and general quality of life.