Analysis Of Anxiety And Depression Status And Its Correlation With Inflammatory Cytokines In Patients With Inflammatory Bowel Disease

Objective: To investigate the status of anxiety and depression in patients with inflammatory bowel disease(IBD)and its correlation with inflammatory cytokines,and analyze the risk factors associated with anxiety and depression in IBD patients,so as to explore their clinical significance.Methods:According to inclusion criteria,81 patients with IBD hospitalized in the department of gastroenterology of The First Affiliated Hospital of Dalian Medical University from July 2017 to January 2019 were enrolled in this study,who were further divided into UC group(61 cases)and CD group(20 cases).According to the modified Mayo score,the UC group was divided into remission group(5 cases),mild group(14cases),moderate group(33 cases),and severe group(9 cases).According to the simplified CDAI score,the CD group was divided into remission group(5 cases),mild group(4 cases),moderate group(6 cases),and severe group(5 cases).The Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were respectively used to evaluate the anxiety and depression status of IBD patients.The levels of serum inflammatory cytokines(IL-6,IL-8,IL-10,IL-1β,TNF-a)and the information of duration of illness,gender,age,marital status,educational background,job status,availability of medical insurance,monthly income were collected by consulting electronic medical records or questionnaires.To analyze the correlation between anxiety,depression and the severity of IBD,the correlation between the level of anxiety anddepression and the levels of serum inflammatory cytokines,as well as the related risk factors of IBD patients with anxiety and depression.SPSS 23.0 statistical software was employed for statistical analysis.The measurement datas were described as mean standard deviation(x±s).The chi-square test or Fisher’s exact test was used to compare Classification variables.Independent data t-test was used to compare normally distributed continuous variables,and Mann-whitney U test was used to compare the continuous variables with non-normal distribution.Risk factors of anxiety and depression in IBD patients were analyzed by binary Logistic regression.P <0.05 was considered statistically significant.Result:1.General information: A total of 81 IBD patients were enrolled,including 52 males and 29 females.The ratio of male to female was 1.79: 1.The age was ranged between18 to 73 years old with an average age being(39.2 ± 14.2)years old.According to the modified Mayo score,61 patients with UC were divided into 5 cases of remission,14 cases of mild,33 cases of moderate and 9 cases of severe.According to the simplified CDAI score,20 patients with CD were divided into 5 cases of remission,4 cases of mild,6 cases of moderate and 5 cases of severe.2.Comparison of anxiety and depression status between the UC group and the CD group: The results showed that there was no statistically significant difference in the anxiety and depression status between the UC group and the CD group(P>0.05)3.Comparison of anxiety and depression among UC patients with different severity:According to the severity,UC patients can be divided into remission group,mild group,moderate group and severe group,the state of anxiety and depression were compared between the groups.The results showed that the difference of anxiety and depression state between four groups was statistically significant(P<0.05).4.Comparison of anxiety and depression among CD patients with different severity:According to the severity,CD patients can be divided into remission group,mild group,moderate group and severe group,the state of anxiety and depression were compared between the groups.The difference of depressive state between four groups wasstatistically significant(P<0.05),and the difference of anxious state has no statistical significance(P>0.05).5.Comparison of inflammatory cytokines levels among IBD patients with different anxiety states: According to the anxiety state,IBD patients were divided into four subgroups: non-anxious,mildly anxious,moderately anxious and severely anxious.After comparing the levels of serum inflammatory cytokines between the four groups,the differences in IL-6,IL-8,IL-1β and TNF-α levels showed statistical significance(P<0.05),while that in IL-10 levels showed no statistical significance(P>0.05).6.Comparison of inflammatory cytokines levels among IBD patients with different depression states: According to their depression state,IBD patients were divided into four subgroups: non-depression,mild depression,moderate depression and severe depression.After comparing the serum levels of inflammatory cytokines between the four groups,the differences in IL-8 and IL-1β levels showed statistical significance(P<0.05),while the differences in IL-6,IL-10 and TNF-α levels showed no statistical significance(P>0.05).7.Correlation analysis of risk factors with anxiety and depression: Single factor analysis showed that duration of illness,monthly income,availability of medical insurance,job status,IL-6,IL-10,TNF-α were significantly correlated with anxiety and depression(P<0.05).Binary logistic regression analysis showed that monthly income and duration of illness were significantly correlated with anxiety and depression(P<0.05),and IL-8 level was significantly correlated with depression(P<0.05).Conclusion:1.Severity of UC was correlated with anxiety and depression,while severity of CD was only correlated with depression,which indicates that the severity of IBD is an important factor causing mental symptoms.2.The level of anxiety and depression in IBD patients is related to the levels of serum IL-6,IL-8 and IL-1β,which indicates that the levels of serum inflammatory cytokines can reflect the degree of anxiety and depression in IBD patients.3.Level of serum IL-8 is an independent risk factor for IBD patients with depression,while economic status and duration of illness are independent risk factors for IBD patients with depression and anxiety.