Newly Diagnosed Crohn’s Disease Treated with Standard Care or Enteral Nutrition: Psychological Outcomes over 6 Months

Abstract

Background and Aim: Impaired health-related quality of life and higher rates of anxiety and depression are observed in patients with Crohn’s disease. This single center study aimed to describe and compare longitudinal psychological outcomes of newly diagnosed Crohn’s disease patients treated with standard care or enteral nutrition to induce remission. Methods:Two separate cohorts of patients were recruited from one center and treated with standard care (n = 22) or enteral nutrition (n = 18) to induce disease remission. Disease activity, quality of life, anxiety, and depression were ­assessed at diagnosis and month 6. Results:At baseline, quality of life (n = 40) was not correlated with disease activity; symptoms of anxiety and depression were present in 15 (38%) and 5 (13%) of the 40 patients, respectively. Significant improvements in quality of life (p <0.0001) and anxiety scores (p = 0.002) were observed after 2 weeks of exclusive enteral nutrition, and at month 6 significant improvements in all psychological outcomes were observed. At month 6, patients who received standard care had a significant improvement in quality of life (p = 0.004), but not in anxiety or depression scores, and there were no differences in psychological outcomes between the treatment groups. Overall, 34/40 (85%) patients were in clinical remission at month 6, and a clinically significant quality of life score was achieved by 31/40 (78%). Conclusions:Patient health-related quality of life and symptoms of anxiety and depression improved as disease activity improved, and 6 months after diagnosis psychological outcomes were similar in patients treated with standard care or enteral nutrition to initially induce remission.