Depression Subtypes in Pediatric Inflammatory Bowel Disease
Corresponding Author
Eva M. Szigethy
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
Address correspondence and reprint requests to Eva Szigethy, MD, PhD, Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA 15224 (e-mail: [email protected]).Search for more papers by this authorAda O. Youk
Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA
Search for more papers by this authorDavid Benhayon
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
Search for more papers by this authorDiane L. Fairclough
Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora
Search for more papers by this authorMelissa C. Newara
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
Search for more papers by this authorMargaret A. Kirshner
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
Search for more papers by this authorSimona I. Bujoreanu
Department of Psychiatry, Boston Children's Hospital, Boston, MA
Search for more papers by this authorChristine Mrakotsky
Department of Psychiatry, Boston Children's Hospital, Boston, MA
Search for more papers by this authorAthos Bousvaros
Department of Pediatric Gastroenterology, Boston Children's Hospital, Boston, MA
Search for more papers by this authorArvind I. Srinath
Department of Pediatric Gastroenterology, Children's Hospital of Pittsburgh, Pittsburgh, PA
Search for more papers by this authorDavid J. Keljo
Department of Pediatric Gastroenterology, Children's Hospital of Pittsburgh, Pittsburgh, PA
Search for more papers by this authorDavid J. Kupfer
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
Search for more papers by this authorDavid R. DeMaso
Department of Psychiatry, Boston Children's Hospital, Boston, MA
Search for more papers by this authorCorresponding Author
Eva M. Szigethy
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
Address correspondence and reprint requests to Eva Szigethy, MD, PhD, Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA 15224 (e-mail: [email protected]).Search for more papers by this authorAda O. Youk
Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA
Search for more papers by this authorDavid Benhayon
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
Search for more papers by this authorDiane L. Fairclough
Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora
Search for more papers by this authorMelissa C. Newara
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
Search for more papers by this authorMargaret A. Kirshner
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
Search for more papers by this authorSimona I. Bujoreanu
Department of Psychiatry, Boston Children's Hospital, Boston, MA
Search for more papers by this authorChristine Mrakotsky
Department of Psychiatry, Boston Children's Hospital, Boston, MA
Search for more papers by this authorAthos Bousvaros
Department of Pediatric Gastroenterology, Boston Children's Hospital, Boston, MA
Search for more papers by this authorArvind I. Srinath
Department of Pediatric Gastroenterology, Children's Hospital of Pittsburgh, Pittsburgh, PA
Search for more papers by this authorDavid J. Keljo
Department of Pediatric Gastroenterology, Children's Hospital of Pittsburgh, Pittsburgh, PA
Search for more papers by this authorDavid J. Kupfer
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
Search for more papers by this authorDavid R. DeMaso
Department of Psychiatry, Boston Children's Hospital, Boston, MA
Search for more papers by this authorThis research was funded by the National Institute of Mental Health (R01 MH077770) and the NIH Director's Innovator Award (1DP2OD001210).
The authors report no conflicts of interest.
ABSTRACT
Objective:
The association between inflammatory bowel disease (IBD) and depression provides a unique opportunity to understand the relation between systemic inflammation and depressive symptom profiles.
Methods:
Youth (n = 226) ages 9 to 17 years with comorbid IBD and depression underwent psychiatric assessment and evaluation of IBD activity. Latent profile analysis (LPA) identified depressive subgroups based on similar responses to the Children's Depression Rating Scale-Revised. Demographic factors, depression severity, anxiety, IBD activity, inflammatory markers, IBD-related medications, and illness perception were evaluated as predictors of profile membership.
Results:
Mean age was 14.3 years; 75% had Crohn disease; 31% were taking systemic corticosteroids. Mean depressive severity was moderate, whereas IBD activity, which reflects inflammation, was mild. LPA identified 3 subgroups: Profile-1 (mild, 75%) had diverse low-grade depressive symptoms and highest quality of life; Profile-2 (somatic, 19%) had severe fatigue, appetite change, anhedonia, decreased motor activity, and depressed mood with concurrent high-dose steroid therapy and the highest IBD activity; and Profile-3 (cognitive, 6%) had the highest rates of self-reported depressive symptoms, ostomy placements, and anxiety with IBD symptoms in the relative absence of inflammation.
Conclusions:
Evidence was found for 3 depression profiles in youth with IBD and depression. Our analyses determined that patients with predominantly somatic or cognitive symptoms of depression comprised 25% of our cohort. These findings may be used to design subgroup-specific interventions for depression in adolescents with IBD and other physical illnesses associated with systemic inflammation.
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