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Feeling Fine: Anxiety and Depressive Symptoms in Youth with Established IBD

Walter, Jennifer G. MS*; Kahn, Stacy A. MD; Noe, Joshua D. MD; Schurman, Jennifer V. PhD§; Miller, Steven A. PhD*; Greenley, Rachel N. PhD*

doi: 10.1097/MIB.0000000000000657
Original Clinical Articles

Background: Previous research is discrepant with respect to the prevalence of internalizing symptoms (i.e., depressive and anxiety symptoms) in pediatric inflammatory bowel disease (IBD) samples. Moreover, few studies have examined the combined influence of demographic and disease-related risk factors for internalizing symptoms. This study described rates of depressive, anxiety, and overall internalizing symptomatology in a multisite sample of youth with established IBD diagnoses. Additionally, the study examined risk factors for elevated depressive, anxiety, and internalizing symptoms, including those in demographic (i.e., family income and sex) and disease (i.e., disease activity and functional disability) domains.

Methods: One hundred sixty-one youth (aged 11–18 yr) with established IBD diagnoses, primarily inactive disease, prescribed oral medications, and who were not taking corticosteroids were recruited from outpatient Gastroenterology Clinics at 3 children's hospitals. This article reflects a secondary analysis of data collected from 2 larger studies examining oral medication adherence and psychosocial functioning in pediatric IBD. After providing written consent/assent, participants completed questionnaires assessing demographics, functional disability, and internalizing symptoms. Medical records were reviewed for disease information and clinical disease activity ratings.

Results: Only 13% of the sample reported clinically elevated anxiety or depressive symptoms. Perceived functional disability, but not clinical disease activity, was associated with higher depressive and anxiety symptoms, and higher overall internalizing symptomatology.

Conclusions: Current results highlight the need to look beyond disease severity and examine the perception of functional disability of patients with IBD when seeking to identify youth at risk for internalizing symptoms such as depression and anxiety.

Article first published online 12 January 2016.

*Department of Pediatrics, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois;

Department of Pediatrics, University of Chicago;

Department of Pediatrics, Medical College of Wisconsin; and

§Department of Developmental and Behavioral Pediatrics, Children's Mercy Hospitals and Clinics.

Reprints: Jennifer G. Walter, MS, Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064 (e-mail:

A portion of this project was funded by the Crohn's and Colitis Foundation of America (Senior Research Award #2838; PI: R.N.G.).

The authors have no conflict of interest to disclose.

Received August 25, 2015

Accepted October 6, 2015

© Crohn's & Colitis Foundation of America, Inc.
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