Psychosocial aspects of inflammatory bowel disease in children

Česká verzia

Authors: E. Karásková ¹; J. Praško ²; D. Jelenová ²; J. Kolářová ¹; M. Hunková ²; M. Ocisková ²; V. Mihál ¹
Authors place of work: Dětská klinika FN a LF UP, Olomouc přednosta prof. MUDr. V. Mihál, CSc. ¹; Psychiatrická klinika FN a LF UP, Olomouc přednosta prof. MUDr. J. Praško, CSc. ²
Published in the journal: Čes-slov Pediat 2016; 71 (2): 111-115.
Category: Review

Summary

Approximately 25% of patients with inflammatory bowel disease (IBD) have the onset of symptoms before the age of 21. The onset of the disease in childhood has its own specifics. The paediatric disease is more aggressive, and negatively affects the quality of life of the patients, their parents and siblings.

Recent research on paediatric IBD patients was performed in Paediatric and Psychiatric Department of University Hospital Olomouc during the years 2013–2015. The aim of the study was to compare the quality of life (questionnaires KidScreen-10 a PedsQL Family Impact Module, the presence of depression (CDI – Children´s Depression Inventory), anxiety disorders (SAD – The Scale of Anxiety in Children) and assessment of heart rate variability in children with IBD and healthy controls. The second aim of the study was to compare anxiety and depression of patient´s parents and parents of healthy children (BDI – Beck Depression Inventory and BAI – Beck Anxiety Inventory). The study included 29 children with IBD aged 13-16 years (15 boys) and 35 healthy controls.

No difference in the incidence of depression in children with IBD compared to healthy controls was found. Decreased heart rate variability was measured, which suggests a reduced adaptability to stress in children with IBD compared to healthy controls. Higher anxiety scores in mothers of IBD patients and higher scores of depression in their fathers were detected, as compared to parents of healthy controls.

Key words:
children, Crohn’s disease, ulcerative colitis, heart rate variability, psychopathology, quality of life

Zdroje

1. Bousvaros A. Use of immunomodulators and biologic therapies in child-ren with inflammatory bowel disease. Expert Rev Clin Immunol 2010 Jul; 6 (4): 659–666.

2. Pigneur B, Seksik P, Viola S, et al. Natural history of Crohn‘s disease: comparison between childhood- and adult-onset disease. Inflamm Bowel Dis 2010 Jun; 16 (6): 953–961.

3. Ruemmele FM, Veres G, Kolho KL, et al. ECCO/ESPGHAN. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn‘s disease. J Crohns Colitis 2014 Oct 1; 8 (10): 1179–1207.

4. Turner D, Levine A, Escher JC, et al. European Crohn‘s and Colitis Organization; European Society for Paediatric Gastroenterology, Hepatology, and Nutrition. Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines. J Pediatr Gastroenterol Nutr 2012 Sep; 55 (3): 340–361.

5. Levine A, Koletzko S, Turner D, et al. ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 2014 Jun; 58 (6): 795–806.

6. Hyams J, Markowitz J, Otley A, et al. Pediatric Inflammatory Bowel Disease Collaborative Research Group. Evaluation of the pediatric crohn disease activity index: a prospective multicenter experience. J Pediatr Gastroenterol Nutr 2005 Oct; 41 (4): 416–421.

7. Turner D, Hyams J, Markowitz J, et al. Pediatric IBD Collaborative Research Group. Appraisal of the pediatric ulcerative colitis activity index (PUCAI). Inflamm Bowel Dis 2009 Aug; 15 (8): 1218–1223.

8. Bryant RV, Winer S, Travis SP, et al. Systematic review: histological remission in inflammatory bowel disease. Is ‚complete‘ remission the new treatment paradigm? An IOIBD initiative. J Crohns Colitis 2014 Dec; 8 (12): 1582–1597.

9. Jelenova D, Prasko J, Ociskova M, et al. Quality of life in adolescents with inflammatory bowel disease – comparison with healthy controls. Neuro Endocrinol Lett 2016 Jan; 36 (8): 787–792.

10. Mackner LM, Greenley RN, Szigethy E, et al. Psychosocial issues in pediatric inflammatory bowel disease: report of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 2013 Apr; 56 (4): 449–458. Review. doi: 10.1097/MPG.0b013e3182841263.

11. Ravens-Sieberer U, Gosch A, Rajmil L, et al. Kidscreen Group E. KIDSCREEN-52 quality-of-life measure for children and ado-lescents. Expert Rev Pharmacoecon Outcomes Res 2005 Jun; 5 (3): 353–364.

12. Varni JW, Sherman SA, Burwinkle TM, et al. The PedsQL Family Impact Module: preliminary reliability and validity. Health Qual Life Outcomes 2004 Sep 27; 2: 55.

13. Gray WN, Boyle SL, Graef DM, et al. Health-related quality of life in youth with Crohn disease: role of disease activity and parenting stress. J Pediatr Gastroenterol Nutr 2015 Jun; 60 (6): 749–753.

14. Jelenova D, Prasko J, Ociskova M, et al. Anxious mothers, helpless fathers, and teenage heroes with IBD. Neuropsychiatric Disease and Treatment (v tisku).

15. Rufo PA. Important health maintenance issues for children and adolescents with inflammatory bowel disease. In: Post TW (Ed). UpToDate, Waltham, MA (Accessed on January 19, 2016).

16. Kovacs M. Rating scales to assess depression in school-aged children. Acta Paedopsychiatr 1981 Feb; 46 (5–6): 305–315.

17. Mullner J, Ruisel I, Farkaš G. Dotazník na meranie úzkosti a úzkostlivosti. Bratislava: 1983, Psychodiagnostické a didaktické testy.

18. DeFilippis EM, Tabani S, et al. Exercise and Self-Reported Limitations in Patients with Inflammatory Bowel Disease. Dig Dis Sci 2016 Jan; 61 (1): 215–220.

19. Bilski J, Mazur-Bialy AI, Wierdak M, et al. The impact of physical activity and nutrition on inflammatory bowel disease: the potential role of cross talk between adipose tissue and skeletal muscle. J Physiol Pharmacol 2013 Apr; 64 (2): 143–155.

20. Pérez CA. Prescription of physical exercise in Crohn‘s disease. J Crohns Colitis 2009 Dec; 3 (4): 225–231.

21. Narula N, Fedorak RN. Exercise and inflammatory bowel disease. Review. Can J Gastroenterol 2008 May; 22 (5): 497–504.

22. Ng V, Millard W, Lebrun C, et al. Low-intensity exercise improves qualityof life in patients with Crohn‘s disease. Clin J Sport Med 2007 Sep; 17 (5): 384–388.

23. Jelenova D, Ociskova M, Prasko J, et al. Heart rate variability in children with inflammatory bowel diseases. Neuro Endocrinol Lett 2015; 36 (1): 72–79.

24. Burke PM, Kocoshis S, Neigut D, et al. Maternal psychiatric disorders in pediatric inflammatory bowel disease and cystic fibrosis. Child Psychiatry Hum Dev 1994 Fall; 25 (1): 45–52.