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Predictors of symptom trajectory in newly diagnosed ulcerative colitis: a 3-year follow-up cohort study.
Van Den Houte, Maaike; Guadagnoli, Livia; Ohman, Lena; Bergstedt, Anders; Johansson, Berndt Zeijlemaker; Simren, Magnus; Strid, Hans; Van Oudenhove, Lukas; Svedlund, Jan.
Afiliação
  • Van Den Houte M; Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research in Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium.
  • Guadagnoli L; Leuven Brain Institute, KU Leuven, Leuven, Belgium.
  • Ohman L; Rehabilitation Research Center (REVAL), Hasselt University, Diepenbeek, Belgium.
  • Bergstedt A; Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research in Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium.
  • Johansson BZ; Leuven Brain Institute, KU Leuven, Leuven, Belgium.
  • Simren M; Department of Microbiology and Immunology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
  • Strid H; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy; University of Gothenburg, Gothenburg, Sweden.
  • Van Oudenhove L; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy; University of Gothenburg, Gothenburg, Sweden.
  • Svedlund J; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Crohns Colitis ; 2024 Mar 29.
Article em En | MEDLINE | ID: mdl-38551078
ABSTRACT
BACKGROUND AND

AIMS:

Psychological symptoms are associated with poorer ulcerative colitis (UC)-related outcomes. However, the majority of research is cross-sectional. We aimed to identify subgroups based on the longitudinal evolution of GI symptom levels and health-related quality of life (HRQoL), and to disentangle the directionality of effects between GI symptom levels and psychological distress.

METHODS:

Self-reported GI symptom severity, HRQoL, inflammatory biomarkers and psychological distress were assessed in 98 newly diagnosed UC patients at disease onset and yearly for 3 consecutive years. Latent class growth analysis was used to determine subgroups based on longitudinal trajectories of symptom severity and HRQoL, and baseline predictors of trajectory group membership were determined. Cross-lagged structural equation models were used to disentangle temporal relationships between psychological functioning and symptom severity.

RESULTS:

Patients with higher initial psychological distress had increased probability of maintaining higher levels of diarrhea and abdominal pain. Conversely, patients with lower initial levels of diarrhea and abdominal pain had higher chances of maintaining lower levels of psychological distress. Higher levels of C-reactive protein at baseline predicted greater improvements in mental health after anti-inflammatory treatment. Reductions in diarrhea and abdominal pain preceded reductions in psychological symptoms over time.

CONCLUSIONS:

Baseline psychological distress is predictive of increased GI symptom severity and reduced mental HRQoL over time, suggesting early assessment of psychological symptoms may identify patients who may have worse disease trajectories. Abdominal pain predicted increased psychological distress, but not the other way around. Intervening on abdominal pain may help prevent or reduce future psychological distress.

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article