Rady Faculty of Health Sciences Scholarly Works

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Browsing Rady Faculty of Health Sciences Scholarly Works by Subject "Anxiety"

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    Depression and anxiety in inflammatory bowel disease: A review of comorbidity and management
    (Inflammatory Bowel Diseases, 2009-07) Graff, Lesley A.; Walker, John R.; Bernstein, Charles N.
    While there has been a great deal of speculation over the years on the importance of emotional factors in inflammatory bowel disease (IBD), it is only in the last decade or so that studies with stronger designs have been available to clarify the nature of this relationship. This review considers recent evidence on the prevalence of anxiety and depressive disorders in IBD, the role of these disorders as a risk factor for IBD onset, the degree to which they affect the course of the IBD, and the contribution of corticosteroid treatment to psychiatric symptom onset. There is evidence that anxiety and depression are more common in patients with IBD and that the symptoms of these conditions are more severe during periods of active disease. The few studies that address the issue of anxiety and depression as risk factors for IBD do not yet provide enough information to support definite conclusions. There is evidence, however, that the course of the disease is worse in depressed patients. Treatment with corticosteroids can induce mood disorders or other psychiatric symptoms. The second part of the review focuses on patient management issues for those with comorbid anxiety or depression. Practical approaches to screening are discussed, and are recommended for routine use in the IBD clinic, especially during periods of active disease. We review evidence-based pharmacological and psychological treatments for anxiety and depression and discuss practical considerations in treating these conditions in the context of IBD to facilitate overall management of the IBD patient.
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    Performance of Administrative case definitions for depression and anxiety in Inflammatory Bowel Disease
    (Journal of Psychosomatic Research, 2016-10) Marrie, Ruth Ann; Walker, John; Graff, Lesley; Lix, Lisa; Bolton, James; Nugent, Zoann; Targownik, Laura; Bernstein, Charles
    Abstract OBJECTIVES: Comorbid depression and anxiety are common in inflammatory bowel disease (IBD), but few population-based estimates of the burden of depression and anxiety exist. Methods to support population-based studies are needed. We aimed to test the performance of administrative case definitions for depression and anxiety in IBD and to understand what the prevalence estimated using such definitions reflects. METHODS: We linked administrative (health claims) data from the province of Manitoba, Canada with clinical data for 266 persons in the Manitoba IBD Cohort Study. We compared the performance of administrative case definitions for depression and anxiety with (a) diagnoses of depression and anxiety as identified based on the Composite International Diagnostic Interview (CIDI), which identifies disorders meeting formal diagnostic criteria, and (b) participant report of physician-diagnosed depression or anxiety. RESULTS: Administrative definitions for depression showed moderate agreement with the CIDI (κ=0.39-0.42). Agreement was higher with participant report of physician-diagnosed depression (κ=0.54). The lifetime prevalence of depression was 29.3% based on the CIDI, 17.7% based on participant report of physician-diagnosed depression, and 21.8-22.5% based on administrative data. Compared to the CIDI, administrative definitions for anxiety showed fair agreement (κ=0.21-0.25). The lifetime prevalence of anxiety was 31.2% based on the CIDI, 9.7% based on participant report of physician-diagnosed anxiety, and 24.4-31.9% based on administrative data. CONCLUSIONS: Administrative data may be used for population-level surveillance of depression and anxiety in IBD, although they will not capture undiagnosed or untreated cases.