Gut and Liver https://doi.org/10.5009/gnl19107 Unmet Psychosocial Needs of Patients Newly Diagnosed with Ulcerative Colitis: Results from the Nationwide Prospective Cohort Study in Korea
Author Information
Jung Rock Moon1 , Chang Kyun Lee1 , Sung Noh Hong2 , Jong Pil Im3 , Byong Duk Ye4 , Jae Myung Cha5 , Sung-Ae Jung6 , Kang-Moon Lee7 , Dong Il Park8 , Yoon Tae Jeen9 , Young Sook Park10 , Jae Hee Cheon11 , Hyesung Kim12 , BoJeong Seo12 , Youngdoe Kim12 , and Hyo Jong Kim1 , the MOSAIK study group of the Korean Association for the Study of Intestinal Diseases (KASID)
1Center for Crohn’s and Colitis, Department of Gastroenterology, Kyung Hee University College of Medicine, 2Department of Medicine, Sungkyunkwan University School of Medicine, 3Department of Internal Medicine, Seoul National University College of Medicine, 4Department of Gastroenterology, University of Ulsan College of Medicine, 5Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, 6Department of Internal Medicine, Ewha Womans University College of Medicine, 7Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 8Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 9Department of Gastroenterology and Hepatology, Korea University College of Medicine, 10Department of Internal Medicine, Eulji University School of Medicine, 11Department of Internal Medicine, Yonsei University College of Medicine, and 12Medical Affairs, Janssen Korea, Seoul, Korea

Chang Kyun Lee
Center for Crohn’s and Colitis, Department of Gastroenterology, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
Tel: +82-2-958-8199, Fax: +82-2-958-8268, E-mail: changkyun.lee@khu.ac.kr
© The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. All rights reserved.

Abstract
Background/Aims: Limited data are available regarding psychosocial distress at the time of diagnosis of ulcerative colitis (UC). We investigated the psychosocial burden and factors related to poor health-related quality of life (HRQL) among patients newly diagnosed with moderate-to-severe UC who were affiliated with the nationwide prospective cohort study. Methods: Within the first 4 weeks of UC diagnosis, all patients were assessed using the Hospital Anxiety and Depression Scale (HADS), Work Productivity and Activity Impairment questionnaire, Inflammatory Bowel Disease Questionnaire (IBDQ), and 12-Item Short Form (SF-12) health survey. A multiple linear regression model was used to identify factors associated with HRQL. Results: Between August 2014 and February 2017, 355 patients completed questionnaires. Significant mood disorders requiring psychological interventions, defined by a HADS score ≥11, were identified in 16.7% (anxiety) and 20.6% (depression) of patients. Patients with severe disease were more likely to have presenteeism, loss of work productivity, and activity loss than those with moderate disease (all p<0.05). Significant mood disorders had the strongest negative relationship with total IBDQ score, which indicates disease-specific HRQL (β coefficient: –22.1 for depression and –40.0 for anxiety, p<0.001). The scores of all SF-12 dimensions, which indicate general HRQL, were remarkably decreased in the study population compared indirectly with previously reported scores in the general population. The Mayo score, C-reactive protein level, and white blood cell count showed significant negative associations with the IBDQ score (p<0.05). Conclusions: Psychosocial screening and timely interventions should be incorporated into the initial care of patients newly diagnosed with UC.
Keywords: Colitis, ulcerative; Patient reported outcome measures; Quality of life; Anxiety; Depression
Abstract
Background/Aims: Limited data are available regarding psychosocial distress at the time of diagnosis of ulcerative colitis (UC). We investigated the psychosocial burden and factors related to poor health-related quality of life (HRQL) among patients newly diagnosed with moderate-to-severe UC who were affiliated with the nationwide prospective cohort study. Methods: Within the first 4 weeks of UC diagnosis, all patients were assessed using the Hospital Anxiety and Depression Scale (HADS), Work Productivity and Activity Impairment questionnaire, Inflammatory Bowel Disease Questionnaire (IBDQ), and 12-Item Short Form (SF-12) health survey. A multiple linear regression model was used to identify factors associated with HRQL. Results: Between August 2014 and February 2017, 355 patients completed questionnaires. Significant mood disorders requiring psychological interventions, defined by a HADS score ≥11, were identified in 16.7% (anxiety) and 20.6% (depression) of patients. Patients with severe disease were more likely to have presenteeism, loss of work productivity, and activity loss than those with moderate disease (all p<0.05). Significant mood disorders had the strongest negative relationship with total IBDQ score, which indicates disease-specific HRQL (β coefficient: –22.1 for depression and –40.0 for anxiety, p<0.001). The scores of all SF-12 dimensions, which indicate general HRQL, were remarkably decreased in the study population compared indirectly with previously reported scores in the general population. The Mayo score, C-reactive protein level, and white blood cell count showed significant negative associations with the IBDQ score (p<0.05). Conclusions: Psychosocial screening and timely interventions should be incorporated into the initial care of patients newly diagnosed with UC.
Keywords: Colitis, ulcerative; Patient reported outcome measures; Quality of life; Anxiety; Depression
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