INFLAMMATORY BOWEL-DISEASE - A STUDY OF THE ASSOCIATION BETWEEN ANXIETY AND DEPRESSION, PHYSICAL MORBIDITY, AND NUTRITIONAL-STATUS

Background: The etiology of inflammatory bowel disease is unclear, and the role played by anxiety and depression is highly controversial. An xiety and depression in patients with inflammatory bowel disease could be secondary to disabling symptoms, but the interaction between physi cal morbidity and psychologic illness in these subjects has not been s ufficiently investigated. Patients with inflammatory bowel disease are nevertheless frequently undernourished, but there are no studies on t he association between anxiety and depression and malnutrition. This s tudy was designed to characterize anxiety and depression in subjects a ffected by inflammatory bowel disease and to establish the influence o f physical morbidity and/or nutritional status on psychologic disorder s. Methods: Seventy-nine consecutive patients, 43 with Crohn's disease (CD) and 36 with ulcerative colitis (UC), were enrolled in the study. An index of the disease activity and physical morbidity was obtained by the simplified Crohn's Disease Activity Index and Truelove-Witts cr iteria and using the Clinical Rating Scale. Thirty-six healthy volunte ers were studied as controls. All the subjects were given the State an d Trait Anxiety Inventory (STAI) test and the Zung self-rating Depress ion Scale. Results: The percentage of subjects with state anxiety was significantly higher in the CD (P < 0.001) and UC (P < 0.001) groups t han in control subjects. There was no significant difference in trait anxiety among groups. The percentage of subjects with depression was s ignificantly higher in the CD (P < 0.05) and UC (P < 0.05) groups than in control subjects. State anxiety and depression were significantly associated with physical morbidity and correlated with malnutrition in CD and UC patients. Conclusion: Anxiety and depression in patients wi th inflammatory bowel disease could be reactive to the disabling sympt oms and to malnutrition. As measured with the STAI, personality trait of anxiety does not seem to play an important role in inflammatory bow el disease.