Abstract Background In inflammatory bowel disease (IBD), symptoms of depression and fatigue overlap to great extent, making it difficult for medical practitioners to differentiate between these symptoms and provide patients with proper treatment options. In this study, we prospectively monitored multiple factors including mood, sleep, physical and psychological wellbeing, quality of life and stress perception, and explored the effects of these factors on symptoms of depression and fatigue in IBD. Our aim was to define specific combinations of symptoms helping to better distinguish between depression and fatigue in IBD populations. Methods Sixteen patients with IBD provided daily indices of sleep duration and quality as well as ratings of depressive symptoms, fatigue, stress perception, mood and IBD-related symptoms 6 times per day for 7 consecutive days of ecological momentary assessment (EMA) monitoring. Additionally, participants were provided with a series of questionnaires, stool samples were collected, as well as ambulatory physiological monitoring was performed. Multiple linear regression analyses were computed to explore how these specific factors can predict depression and fatigue in IBD. Network analyses were applied to identify and analyse distinct patterns of statistical associations related to depression and fatigue in IBD. Results Self-reported sleep quality (pFDR = .034) and feelings of sadness (pFDR = .045) significantly predicted symptoms of depression in IBD, while fatigue could only be predicted by poor sleep quality (pFDR = .030). Network analyses revealed two distinct patterns: symptoms of depression were associated with less positive (pFDR = .024) and more negative affect (pFDR = .012), as well as stronger feelings of tiredness (pFDR = .014) in daily life. Fatigue was characterized by an inability of feeling relaxed (pFDR = .002), more severe tiredness (pFDR = .013) and exhaustion (pFDR = .022). Conclusion Our preliminary results indicate that depressive symptoms are associated with the experience of negative emotions in daily life, which could affect patients‘ motivation to engage in activities and social interactions and thus, resulting in a stronger perception of tiredness. In contrast, the manifestation of fatigue in IBD is characterised by a stronger perception of tiredness and exhaustion, but not with the experience of negative affect. Additionally to the improvement of patient’s sleep quality, treatment of depressive symptoms should focus on fostering daily activities linked to positive emotions, while relaxation techniques and regular amount of moderate exercise can be a good treatment option for fatigued patients, if these associations could be found in larger studies as well.
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