Dataset Information

Psychological Factors May Play an Important Role in Pediatric Crohn's Disease Symptoms and Disability.

ABSTRACT:

Objective

To examine the relative contributions of disease activity and psychological factors to self-reported symptoms and disability in children with Crohn's disease.

Study design

Participants (n = 127 children age 8-18 years) completed questionnaires on symptom severity and disability, as well as psychological measures assessing anxiety, depression, pain beliefs and coping. Disease activity was measured by the Pediatric Crohn's Disease Activity Index. Structural equation modeling was used to test the effects of disease activity and psychological factors on symptoms and disability.

Results

In the hypothesized model predicting symptoms, psychological factors (β = 0.58; P < .001) were significantly associated with disease symptoms but disease activity was not. The model for disability yielded significant associations for both psychological factors (β = 0.75; P < .001) and disease activity (β = 0.61, P < .05).

Conclusion

Crohn's disease symptoms in children and adolescents are not only driven by disease activity. Coping, anxiety, depression, and cognition of illness are important in the patient-reporting of symptom severity and disability. Physicians need to be aware that symptom self-reporting can be driven by psychological factors and may not always be simply an indicator of disease activity.

Trial registration

ClinicalTrials.gov: NCT00679003.

SUBMITTER: van Tilburg MAL

PROVIDER: S-EPMC5407185 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Publications

Psychological Factors May Play an Important Role in Pediatric Crohn's Disease Symptoms and Disability.

van Tilburg Miranda A L MAL Claar Robyn Lewis RL Romano Joan M JM Langer Shelby L SL Drossman Douglas A DA Whitehead William E WE Abdullah Bisher B Levy Rona L RL

The Journal of pediatrics 20170224

<h4>Objective</h4>To examine the relative contributions of disease activity and psychological factors to self-reported symptoms and disability in children with Crohn's disease.<h4>Study design</h4>Participants (n = 127 children age 8-18 years) completed questionnaires on symptom severity and disability, as well as psychological measures assessing anxiety, depression, pain beliefs and coping. Disease activity was measured by the Pediatric Crohn's Disease Activity Index. Structural equation modeli ...[more]

PMID: 28238483

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Project description:BackgroundWhile the grading of intestinal fibrosis is closely related to the therapeutic strategy of patients with Crohn's disease (CD), it has not yet been well resolved. Mesenteric abnormalities are inextricably linked to intestinal fibrosis.ObjectivesWe aimed to establish an optimal model for assessing intestinal fibrosis using computed tomography enterography (CTE) and clinical markers.DesignA total of 174 patients with CD between January 2014 and June 2020 were included in this retrospective multicentre study.MethodsAll patients underwent CTE within 3 months prior to surgery. Intestinal fibrosis was pathologically scored as non-mild or moderate-to-severe. Selected imaging of the intestinal walls and mesentery and/or clinical factors were used to develop the diagnostic models. The area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the discrimination performance of the models. A decision curve analysis was performed to evaluate the clinical usefulness of the models.ResultsOne-, two-, and three-variable models were identified as possible diagnostic models. Model 1 [mesenteric creeping fat index (MCFI)], Model 2 (mesenteric oedema and MCFI), and Model 3 (mesenteric oedema, MCFI, and disease duration) were established. The AUCs of Model 1 in training and test cohorts 1 and 2 were 0.799, 0.859, and 0.693, respectively; Model 2 was 0.851, 0.833, and 0.757, respectively; and Model 3 was 0.832, 0.821, and 0.850, respectively. We did not observe any significant difference in diagnostic performance between the training and total test cohorts in any model (all p > 0.05). The decision curves showed that Model 3 had the highest net clinical benefit in test cohort 2. The nomogram of this optimal model was constructed by considering the favourable and robust performance of Model 3.ConclusionA nomogram integrating mesenteric abnormalities on CTE with a clinical marker was optimal for differentiating between non-mild and moderate-to-severe fibrosis in patients with CD.

Dataset Information

Psychological Factors May Play an Important Role in Pediatric Crohn's Disease Symptoms and Disability.

Objective

Study design

Results

Conclusion

Trial registration

Publications

Psychological Factors May Play an Important Role in Pediatric Crohn's Disease Symptoms and Disability.

Similar Datasets

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