Sebastian Bruno Ulrich Jordi1,2, Federica Botte2, Brian Matthew Lang3, Thomas Greuter1, Niklas Krupka2, Bianca Auschra4, Philipp Schreiner1, Michael Christian Sulz5, Luc Biedermann1, Roland von Känel4, Gerhard Rogler1, Stefan Begré6,7, Benjamin Misselwitz2. 1. Department of Gastroenterology and Hepatology, University Hospital Zurich and Zurich University, Zurich, Switzerland. 2. Clinic for Visceral Surgery and Medicine, Inselspital Bern and Bern University, Bern, Switzerland. 3. Clinic for Transplantation Immunology and Nephrology (Swiss Transplant Cohort Study), University Hospital of Basel, Basel, Switzerland. 4. Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 5. Department of Gastroenterology and Hepatology, Kantonsspital St. Gallen, St. Gallen, Switzerland. 6. Neurology, Department of Biomedical Research, Bern University Hospital, University of Bern, Bern, Switzerland. 7. ISFOM - Institute of Stress Diseases and Stress Management, Zurich, Switzerland.
Abstract
BACKGROUND: Inflammatory bowel disease (IBD) can be exacerbated by stress and depression. Type D personality, characterised by high negative affectivity and social inhibition, represents a vulnerability towards stressors and is associated with adverse outcomes in coronary heart disease. AIMS: To assess the prevalence of Type D personality in IBD patients and investigate potential associations with disease course. METHODS: We tested for associations between Type D (Type D Scale-14), depressive symptoms (Hospital Anxiety and Depression Scale's depression subscore ≥11) and recurrent IBD amongst Swiss IBD cohort patients. We built regression models for cross-sectional and Cox proportional hazards models for time-to-event analyses. IBD disease course was assessed by the future occurrence of active disease (Crohn's Disease Activity Index ≥150/Modified Truelove & Witts activity index ≥10) and several IBD-relevant endpoints. RESULTS: Amongst 2275 patients (1005 ulcerative colitis, 1270 Crohn's disease), 672 (29.5%) had Type D. Type D was a significant risk factor for future active disease (adjusted hazard ratio, aHR: 1.60, corrected P value, q = 0.007) and predicted the future presence of depressive symptoms (aHR: 3.30, P < 0.001). The combination of Type D and depressive symptoms further increased the risk for active disease (aHR: 3.98, q < 0.001). However, Type D associated depressive symptoms seemed to be the main contributor to this effect as Type D's predictive power decreased considerably in models corrected for depressive symptoms (aHR: 1.32, CI: 0.97-1.79, q = 0.292). CONCLUSIONS: Type D personality's prevalence amongst IBD patients was comparable with its prevalence in the general population. Type D was strongly associated with depressive symptoms and showed modest independent associations with IBD prognosis.
BACKGROUND:Inflammatory bowel disease (IBD) can be exacerbated by stress and depression. Type D personality, characterised by high negative affectivity and social inhibition, represents a vulnerability towards stressors and is associated with adverse outcomes in coronary heart disease. AIMS: To assess the prevalence of Type D personality in IBDpatients and investigate potential associations with disease course. METHODS: We tested for associations between Type D (Type D Scale-14), depressive symptoms (Hospital Anxiety and Depression Scale's depression subscore ≥11) and recurrent IBD amongst Swiss IBD cohort patients. We built regression models for cross-sectional and Cox proportional hazards models for time-to-event analyses. IBD disease course was assessed by the future occurrence of active disease (Crohn's Disease Activity Index ≥150/Modified Truelove & Witts activity index ≥10) and several IBD-relevant endpoints. RESULTS: Amongst 2275 patients (1005 ulcerative colitis, 1270 Crohn's disease), 672 (29.5%) had Type D. Type D was a significant risk factor for future active disease (adjusted hazard ratio, aHR: 1.60, corrected P value, q = 0.007) and predicted the future presence of depressive symptoms (aHR: 3.30, P < 0.001). The combination of Type D and depressive symptoms further increased the risk for active disease (aHR: 3.98, q < 0.001). However, Type D associated depressive symptoms seemed to be the main contributor to this effect as Type D's predictive power decreased considerably in models corrected for depressive symptoms (aHR: 1.32, CI: 0.97-1.79, q = 0.292). CONCLUSIONS: Type D personality's prevalence amongst IBDpatients was comparable with its prevalence in the general population. Type D was strongly associated with depressive symptoms and showed modest independent associations with IBD prognosis.
Authors: Stefan Begré; Benjamin Misselwitz; Sebastian Bruno Ulrich Jordi; Brian Matthew Lang; Jacqueline Wyss; Bianca Auschra; Bahtiyar Yilmaz; Niklas Krupka; Thomas Greuter; Philipp Schreiner; Luc Biedermann; Martin Preisig; Roland von Känel; Gerhard Rogler Journal: J Gastroenterol Date: 2022-07-28 Impact factor: 6.772