학술논문

Type D personality is associated with depressive symptoms and clinical activity in inflammatory bowel disease.
Document Type
Article
Source
Alimentary Pharmacology & Therapeutics. Jul2021, Vol. 54 Issue 1, p53-67. 15p. 1 Diagram, 3 Charts, 5 Graphs.
Subject
*MENTAL depression
*INFLAMMATORY bowel diseases
*CROHN'S disease
*PSYCHOLOGICAL typologies
*PROPORTIONAL hazards models
*ULCERATIVE colitis
Language
ISSN
0269-2813
Abstract
Summary: 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 DScale‐14), depressive symptoms (Hospital Anxiety and DepressionScale'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 ActivityIndex ≥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. [ABSTRACT FROM AUTHOR]