克罗恩病患者焦虑抑郁状况及其影响因素分析

目的：分析克罗恩病（Crohn’s disease, CD）患者的精神心理状况，研究CD患者焦虑和抑郁相关影响因素及其对患者健康生命质量的影响。 方法：收集2021年2月至2022年2月就诊于复旦大学附属中山医院的CD患者共100例，采集人口统计学资料及疾病相关信息，研究对象填写焦虑自评量表( SAS)、抑郁自评量表( SDS) 、患者报告结局（PRO2）、炎症性肠病患者生活质量分析表（IBDQ）和FACIT-F疲劳量表。采用卡方检验和logistic回归检验分析焦虑、抑郁相关影响因素，独立样本t检验分析焦虑、抑郁对IBDQ和FACIT-F评分的影响。 结果：CD患者合并焦虑、抑郁的比例明显高于健康对照组（焦虑：58% vs 9.4%；抑郁：43% vs 11.8%，P < 0.001），SAS和SDS评分显著增高；患者为女性、具有肠外表现、根据患者自我报告症状评估疾病处于活动期为焦虑危险因素，文化程度和患者自我报告症状评估疾病处于活动期是抑郁危险因素；具有焦虑和抑郁情绪的患者IBDQ（焦虑：171.24 ± 24.30 vs 190.95 ± 20.61, P < 0.001；抑郁：170.47 ± 27.97 vs 186.35 ± 19.59, P = 0.002）和FACIT-F（焦虑：12.53 ± 6.15 vs 15.62 ± 7.65, P= 0.028；抑郁：9.44 ± 4.08 vs 17.14 ± 6.86 , P < 0.001）评分明显降低。 结论：CD患者发生焦虑、抑郁的风险高于一般人群，焦虑和抑郁发生风险与疾病活动密切相关，具有焦虑和抑郁情绪的患者更易感到疲劳，健康生命质量显著下降。

Risk factors of anxiety and depression in patients with Crohn's disease

Objective To analyze the psychological symptoms in patients with Crohn''s disease, and to investigate the risk factors of anxiety and depression and its effect on health-related quality of life. Methods A total of 100 patients with Crohn''s disease from Feb. 2021 to Feb. 2022 in Zhongshan Hospital, Fudan University were recruited. Demographics and disease characteristic informations of patients were collected. Self-rating anxiety scale (SAS), self-rating depression scale (SDS), a two-item patient-reported outcome (PRO2), inflammatory bowel disease quality of life questionnaire (IBDQ), and the functional assessment of chronic illness therapy-fatigue (FACIT-F) scale were used to estimate the psychological condition and quality of life of patients. Chi-square test and logistic regression were used to analyze the influencing factors of anxiety and depression, and independent sample t test was used to analyze the effect of anxiety and depression on IBDQ and FACIT-F scores in patients. Results The incidences of anxiety and depression in CD patients were significantly higher than healthy controls (anxiety:58.0% vs 9.4%, P<0.001; depression:43.0% vs 11.8%, P<0.001). Female, extraintestinal manifestations, and disease activity were associated with anxiety, while higher degree of education and disease activity were associated with depression. IBDQ and FACIT-F scores were significantly lower in patients with anxiety and depression (P<0.05). Conclusions The incidences of anxiety and depression in patients with CD are significantly higher than those in the general population. The risk of anxiety and depression is closely related to disease activity, and CD patients with anxiety and depression are more likely to have fatigue and lower health-related quality of life.