Comparison Of Depression And Anxiety İn İnflammatory Bowel Patients Treated With Anti-Tnf Or İmmune Modulators

Thesis Type: Expertise In Medicine

Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey

Approval Date: 2019

Thesis Language: Turkish




Objects: The aim of this study was to determine, patients diagnosed with IBD, the incidence of depression and anxiety and compare the effects of anti inflammatory treatment options on depression and anxiety. Methods: This is a single-center prospective study.A total of 94 patients, 51 had ulcerative colitis and 43 had Crohn's disease, with ages ranging from 18 to 65 were included in our study.Data were obtained with Sociodemographic Data Form, Beck Depression Scale and Beck Anxiety Scale.For the patients with Crohn's and Ulcerative Colitis respectively, Harvey-Bradshaw activity scores and Mayo Clinical activation scores were calculated.Comparison between groups was performed by non-parametric Mann Whitney U test and comparison of dependent data groups was performed by Wilcoxon test which is non parametric. The correlation between the variables was investigated by correlation coefficient. P values less than 0,05 were considered significant. Results: The mean age in the UC group was 40,25 ± 14 years andin the CH group was 38,9 ± 13,8.No significant difference was observed between the groups in terms of age and gender. According to Harvey-Bradshaw index, which is an indicator of activation for Crohn's disease, 46% of Crohn's patients had mild disease and 53,5% had moderate disease.According to the ulcerative colitis activity index of the Mayo Clinic, 9,8% of UC patients had mild disease, 86,3% had moderate disease and 3,9% had severe disease.Before the treatment, 12,8% of the patients were normal, 63,8% had mild depression, 22,3% had moderate depression and 1,1% had severe depression. Before treatment, 23,4% of the patients had minimal anxiety, 64,9% had mild anxiety, 11,7% had moderate anxiety. There was a positive correlation between disease activation and depression and anxiety in both ulcerative colitis and crohn's patients (p<0,05). When the depression and anxiety levels were compared in all patient groups before and after treatment, a statistically significant difference was found in the direction of improvement (p<0,001). When the treatment options in all patient groups were examined, there was a significant difference in depression and anxiety levels before and after the treatment in all treatment groups except for those who were started with sertolizumab (p<0,05). Discussion: According to the results of our study, anxiety and depression are one of the clinical problems that should be considered in patients with IBD.There is a positive correlation between disease activation score and depression-anxiety score in IBD patients.Immunosuppressive and immunomodulatory drugs aimed at remission of inflammatory bowel disease can also improve psychological parameters as well as this disease.