SALT LAKE CITY – Watch for signs of depression in adolescents with inflammatory bowel disease, especially if they are older, have more severe disease, are on steroids, or report family conflict, Dr. Eva Szigethy said.
A study of 141 adolescents with Crohn's disease and 52 with ulcerative colitis seen in a pediatric gastroenterology clinic used a slew of assessment tools to measure disease severity, screen for depression, and assess psychosocial factors in the patients' lives. A total of 43 patients with a Child Depression Inventory score of 9 or greater (suggesting increased risk for depression) underwent a comprehensive psychiatric evaluation using the Kiddie Schedule for Affective Disorders and Schizophrenia.
Of the 43, 2 had major depression, 14 had minor depression, and 27 had depressive symptoms, Dr. Szigethy said at a poster presentation at the annual meeting of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
Patients who self-reported poor family functioning, poor personal health, or poor physical functioning were more likely to be depressed. The patients on steroids–especially higher doses–had more depression. Disease severity and older age were risk factors for depression, she and her associates reported.
“The whole idea is to pick up depression before it becomes a full-blown, clinical, major depression and becomes functionally incapacitating,” Dr. Szigethy, a pediatric psychiatrist at the University of Pittsburgh who is also in the university medical center's inflammatory bowel disease program, said in an interview.
Risk factors for depression need to be assessed routinely in outpatient pediatric clinics to enhance comprehensive care for these patients, the investigators concluded.
Untreated depression increases the likelihood that patients with inflammatory bowel disease will not adhere to medication regimens, leading to treatment failure, other studies have shown.
Unlike some other studies that suggested an association between parental psychopathology and depression risk in adolescents with inflammatory bowel disease, the current study found no significant effect of parental history of depression, parental psychopathology, or life stressors on the youth's risk for depression.
The investigators also plan to study patients who are younger than the 11− to 17-year-olds in the current study.