Studies On Psychological Health And Quality Of Life In Patients With Crohn's Disease

Aim:To explore the relationship between disease severity,illness perceptions,coping strategies,stress,anxiety,depression and quality of life(Qo L)in patients with Crohn's disease(CD).To evaluate the effect of infliximab(IFX)on disease severity,Qo L and psychological health in newly-diagnosed CD patients.Methods:Two hundred and one CD patients managed in department of gastroenterology in our hospital from January 2015 to June 2016were enrolled.Disease severity was measured with the Harvey-Bradshaw Index(HBI),illness perceptions assessed with the Brief Illness Perceptions Questionnaire(BIPQ),coping strategies evaluated with the Carver Brief Coping Questionnaire(Brief COPE),stress explored with the Perceived Stress Questionnaire(PSQ),anxiety and depression measured with the Hospital Anxiety and Depression Scale(HADS)and Qo L assessed with the Inflammatory Bowel Disease Questionnaire(IBDQ).Analysis of the interrelationships between these variables was made.Newly-diagnosed patients treated with IFX were also asked to participate in the follow-up study,in whom comparison of their disease severity,Qo L,anxiety and depression before and 6 infusions after IFX treatment was made.Results:Significant correlations were observed between disease severity,illness perceptions,coping strategies,stress,anxiety,depression and Qo L in CD patients(P<0.001).A Structural Equation Modeling(SEM)was introduced for analysis of these variables.(?~2(10)=16.87,P=0.08,?~2/N=1.69,SRMR<0.05,RMSEA<0.06,GFI>0.97,CFI>0.99).Disease severity directly influenced patient's illness perceptions and Qo L.Illness perceptions directly influenced patient's stress,anxiety,depression and Qo L.Stress directly influenced patient's anxiety,depression and Qo L,while coping strategies didn't have a direct influence on anxiety,depression or Qo L.Anxiety directly influenced patient's Qo L.After6-infusion IFX treatment,patient's disease severity,Qo L and anxiety were significantly improved(P<0.001),but depression wasn't alleviated(P(29)0.05).All four dimensions in Qo L including bowel symptoms,systemic symptoms,emotional well-being and social function were significantly improved(P<0.001).Significant correlations were observed between disease severity,Qo L,anxiety and depression both before and after IFX treatment(P<0.01).Conclusions:Factors associated with physical and psychological health in CD patients had complex interrelationships with each other.Association between individual's disease severity and anxiety,depression and Qo L could be mediated by illness perceptions and stress,while coping strategies had no such functioning.Both physical and psychological health in newly-diagnosed CD patients were greatly improved after 6-infusion IFX.