Well-being and flourishing mental health in adults with inflammatory bowel disease, multiple sclerosis and rheumatoid arthritis in Manitoba, Canada: a cross-sectional study.

Autor:	Almweisheer S; Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada., Bernstein CN; Department of Gastroenterology, University of Manitoba, Winnipeg, Manitoba, Canada., Graff LA; Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada., Patten SB; Community Health Sciences & Psychiatry, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada., Bolton J; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada., Fisk JD; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.; Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., Hitchon CA; Internal Medicine, University of Manitoba College of Medicine, Winnipeg, Manitoba, Canada., Marriott JJ; Internal Medicine, University of Manitoba College of Medicine, Winnipeg, Manitoba, Canada., Marrie RA; Internal Medicine, University of Manitoba College of Medicine, Winnipeg, Manitoba, Canada rmarrie@hsc.mb.ca.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Jun 09; Vol. 13 (6), pp. e073782. Date of Electronic Publication: 2023 Jun 09.
DOI:	10.1136/bmjopen-2023-073782
Abstrakt:	Objectives: Among people with immune-mediated inflammatory disease (IMID), including multiple sclerosis (MS), inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) most research has focused on mental illness rather than on mental health. We assessed dimensions of mental health among persons with IMID and compared them across IMID. We also evaluated demographic and clinical characteristics associated with flourishing mental health. Design: Participants: Adults with an IMID (MS, 239; IBD, 225; RA 134; total 598) who were participating in a cohort study. Setting: Tertiary care centre in Manitoba, Canada. Primary Outcome Measure: Participants completed the Mental Health Continuum Short-Form (MHC-SF), which measures emotional, psychological and social well-being, and identifies flourishing mental health. This outcome was added midway through the study on the advice of the patient advisory group. Depression, anxiety, pain, fatigue and physical function were also assessed. Results: Total MHC-SF and subscale scores were similar across IMID groups. Nearly 60% of participants were considered to have flourishing mental health, with similar proportions across disease types (MS 56.5%; IBD 58.7%; RA 59%, p=0.95). Older age was associated with a 2% increased odds of flourishing mental health per year of age (OR 1.02; 95% CI: 1.01 to 1.04). Clinically meaningful elevations in anxiety (OR 0.25; 95% CI: 0.12 to 0.51) and depressive symptoms (OR 0.074; 95% CI: 0.009 to 0.61) were associated with lower odds. Higher levels of pain, anxiety and depressive symptoms were associated with lower total Mental Health Continuum scores at the 50th quantile. Conclusions: Over half of people with MS, IBD and RA reported flourishing mental health, with levels similar across the disease groups. Interventions targeting symptoms of depression and anxiety, and upper limb impairments, as well as resilience training may help a higher proportion of the IMID population achieve flourishing mental health. Competing Interests: Competing interests: SA has no conflicts to declare. LAG has consulted to Roche Canada. She receives research funding from CIHR, the Multiple Sclerosis Society of Canada and Crohn’s and Colitis Canada. CNB receives research funding from CIHR, Brain and Behavior Research Foundation, Crohn’s and Colitis Canada and the MS Society of Canada. JDF receives research grant support from the Canadian Institutes of Health Research, the National Multiple Sclerosis Society, the Multiple Sclerosis Society of Canada, Crohn’s and Colitis Canada, Research Nova Scotia; consultation and distribution royalties from MAPI Research Trust. Lisa M Lix receives research funds from CIHR, NSERC and the Arthritis Society. SBP receives research funding from CIHR, the MS Society of Canada, Roche, Biogen and the Government of Alberta. CNB is supported by the Bingham Chair in Gastroenterology. CNB has served on advisory Boards for AbbVie Canada, Amgen Canada, Bristol Myers Squibb Canada, JAMP Pharmaceuticals, Lilly Canada, Roche Canada, Janssen Canada, Sandoz Canada, Takeda Canada and Pfizer Canada; consultant for Mylan Pharmaceuticals and Takeda; educational grants from AbbVie Canada, Pfizer Canada, Takeda Canada and Janssen Canada. Speaker’s panel for AbbVie Canada, Janssen Canada, Pfizer Canada and Takeda Canada. Received research funding from AbbVie Canada, Amgen Canada, Sandoz Canada, Takeda Canada and Pfizer Canada. JJM has conducted trials for Biogen Idec and Roche, and receives research funding from the MS Society of Canada. CAH has served on an Advisory Board for AstraZeneca Canada, and has received unrelated research funding from Pfizer Canada, Public Health Agency of Canada and Health Sciences Centre Foundation. RAM is a co-investigator on a study funded by Biogen Idec and Roche (no funds to her/her institution). RAM receives research funding from: CIHR, Research Manitoba, Multiple Sclerosis Society of Canada, Multiple Sclerosis Scientific Foundation, Crohn’s and Colitis Canada, National Multiple Sclerosis Society, CMSC, the Arthritis Society and the US Department of Defense and is a co-investigator on studies receiving funding from Biogen Idec and Roche Canada. She holds the Waugh Family Chair in Multiple Sclerosis. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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