Systematic review: psychological morbidity in young people with inflammatory bowel disease - risk factors and impacts.

Autor: Brooks AJ; Academic Department of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK., Rowse G; Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK., Ryder A; Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK., Peach EJ; Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK., Corfe BM; Molecular Gastroenterology Research Group, Academic Unit of Surgical Oncology, Department of Oncology, The Medical School, Sheffield, UK., Lobo AJ; Academic Department of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK.
Jazyk: angličtina
Zdroj: Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2016 Jul; Vol. 44 (1), pp. 3-15. Date of Electronic Publication: 2016 May 04.
DOI: 10.1111/apt.13645
Abstrakt: Background: Psychological morbidity in young people aged 10-24 years, with inflammatory bowel disease (IBD) is increased, but risk factors for and impacts of this are unclear.
Aim: To undertake a systematic literature review of the risk factors for and impact of psychological morbidity in young people with IBD.
Methods: Electronic searches for English-language articles were performed with keywords relating to psychological morbidity according to DSM-IV and subsequent criteria; young people; and IBD in the MEDLINE, PsychInfo, Web of Science and CINAHL databases for studies published from 1994 to September 2014.
Results: One thousand four hundred and forty-four studies were identified, of which 30 met the inclusion criteria. The majority measured depression and anxiety symptoms, with a small proportion examining externalising behaviours. Identifiable risk factors for psychological morbidity included: increased disease severity (r(2) = 0.152, P < 0.001), lower socioeconomic status (r(2) = 0.046, P < 0.001), corticosteroids (P ≤ 0.001), parental stress (r = 0.35, P < 0.001) and older age at diagnosis (r = 0.28, P = 0.0006). Impacts of psychological morbidity in young people with IBD were wide-ranging and included abdominal pain (r = 0.33; P < 0.001), sleep dysfunction (P < 0.05), psychotropic drug use (HR 4.16, 95% CI 2.76-6.27), non-adherence to medication (12.6% reduction) and negative illness perceptions (r = -0.43).
Conclusions: Psychological morbidity affects young people with IBD in a range of ways, highlighting the need for psychological interventions to improve outcomes. Identified risk factors provide an opportunity to develop targeted therapies for a vulnerable group. Further research is required to examine groups under-represented in this review, such as those with severe IBD and those from ethnic minorities.
(© 2016 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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