Background: Previous studies have demonstrated that patients with inflammatory bowel disease (IBD) have increased vulnerability for psychological symptoms. However, the further investigation of the psychological symptoms and impaired daily function in Chinese patients with Crohn's disease (CD) is not well described. Our aim is to estimate the psychological symptoms and daily function of the patients with CD comparing with health controls and the risk factors for psychological symptoms of the Chinese patients with CD.
Methods: A cross-sectional study was undertaken including 169 patients with CD and 174 healthy controls. The Research Electronic Data Capture (REDCap) were adopted to perform web-based surveys. Sociodemographic variables including age, gender, employment state, marriage state, education, place of residence and fertility, clinical variables including surgery history, stoma, course of disease, therapy and disease activity estimated by the Harvey-Bradshaw Index (HBI), psychological symptoms measured by the Depression Anxiety Stress Scales (DASS-21), daily function measured by the Work and Social Adjustment Scale (WSAS) were estimated in both patients with CD and healthy controls. Chi-square test was performed to identify differences of psychological symptoms and daily function between the patients with CD and the controls. Logistic regression was performed to identify the risk factors associated with psychological symptoms in patients with CD.
Results: The median age of the patients with CD and the controls was 30.75±10.79 and 30.99±8.48 years old, respectively. The patients with CD experienced elevated depression symptoms (10/169, 14.8%), anxiety symptoms (40/169, 23.6%) and impaired daily function (92/169, 54.5%) than the controls (10/174, 1.4%; 14/174, 8.0%; 14/174, 8.0%, respectively). The patients with active CD experienced elevated anxiety symptoms (25/72, 34.7%) and impaired daily function (49/72, 68.1%) than the patients in remission (15/97, 15.5%; 38/97, 39.2%). Urban life (OR=2.631, 95% CI: 1.176 to 5.885) is the independent risk factor for psychological symptoms.
Conclusions: The Chinese Patients with CD experience elevated psychological symptoms and impaired daily function, particular the Patients in activity diseases state. Urban life is the independent risk factor for psychological symptoms. So the Chinese Patients with CD need psychological assessment and support.