Psychological factors, rather than disease activity, were significantly associated with symptoms in children and teens with Crohn’s disease, based on data from 127 children aged 8-18 years.
Patients completed questionnaires on symptom severity and disability, as well as psychological measures assessing anxiety, depression, pain beliefs, and coping. Disease activity was measured by the Pediatric Crohn’s Disease Activity Index.
The researchers used a model to assess how psychology factors and disease activity impacted symptoms and disability.
The disability model showed significant associations with both psychological factors (P less than .001) and disease activity (P less than .05). However, the symptoms model showed a significant association only with psychological factors (P less than .001).
“One possible explanation for our findings is that many patients with Crohn’s disease report elevated levels of psychological distress,” wrote Miranda A. L. van Tilburg, PhD, of the University of North Carolina at Chapel Hill and colleagues.
Although the study was limited by the use of self-reports, “this finding is an important one because symptom presentation often plays an important role in treatment decisions, which could lead to unnecessary exposure to tests and treatments, with potential negative side effects,” the researchers wrote. “When confronted with a pediatric patient with Crohn’s disease who has high levels of psychological distress, independent of his or her inflammatory status, the clinician should consider incorporating behavioral techniques such as education, reassurance, and cognitive behavior therapy into the management plan,” they said.
The researchers had no financial conflicts to disclose.
Read the full study here: doi: 10.1016/j.jpeds.2017.01.058.