Oscilação do humor em pacientes com doença de Crohn : incidência e fatores associados

Abstract

Introduction: Crohn Disease (CD) is a chronic inflammatory bowel disease not curable until now. Although psychological issues have been initially considered participants in the etiology of CD this hypothesis was is currently discharged. There are rising evidence that depressive symptoms and anxiety are very frequently in these patients, but little data about humor oscillation and it influence in clinical course of the disease is available. Objective: Estimate the incidence of mood disorders in patients with CD and the possible issues associated with them. Methodology: This prospective longitudinal study evaluate 50 patients (60% female gender; mean age 40.6 yrs) with CD assisted by our institution in a 16 months period time. The clinic activity of the disease was measured by the Crohn’s Activity Index and the mood disorders by Beck Depression Inventory and Hospital Anxiety Scale. The instruments used to assess psychological status were applied in the inclusion and then each four months. Results: The major phenotype of CD found was the inflammatory (86%), 36% had a past history of surgery due to CD complications, 82% had no active disease in the admission period. Humor oscillation (HO) was observed in 58% of patients; 28% had depressive and or anxiety symptoms and 30% had normalization of their baseline depressive or anxiety humor. In 38% of the patients with HO there was no change in disease activity 9p:0.015), while 20% had some degree of variation in clinical activity. Female gender and the absence of previous surgery related to CD were associated with HO (p:0.04). Conclusion: Female gender and the absence of previous surgery due to CD’s complications were associated with HO. Periodically Female gender and previous surgery related to CD’s complication are associated with HO. Periodically psychological evaluation can be worthy for detection and management of HO patients with CD.