Effect of parental and child coping on clinical and behavioral outcomes in children with newly diagnosed IBD: a longitudinal cohort study
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Abstract
BACKGROUND and AIMS: A new diagnosis of Inflammatory Bowel Disease (IBD) affects both the patient and their family unit and has been shown to significantly impact the child’s quality of life (QoL). The current study extends the literature by assessing the relationship between parental anxiety and depression on the QoL of their child with newly diagnosed IBD as well as subsequent healthcare utilization. METHODS: We recruited dyads of children (aged 9-17) with newly diagnosed IBD (within six months) and their parents for this study. Children independently completed an IBD-specific QoL metric (IMPACT-III), depression metrics (CDI and PHQ-9), and an anxiety metric (SCARED). Parents completed the Hospital Anxiety and Depression (HADS) metric to assess for the presence and severity of comorbid anxiety and depression, an inventory assessing stressors related to caring for a child with a chronic illness (PIP), and a healthcare utilization survey. A review of the EMR was performed to collect disease-specific indices. Statistical analysis was achieved using the Fisher Exact test and a two-tailed t-test. RESULTS: We enrolled 80 child/parent dyads (55 with Crohn’s disease, 22 with ulcerative colitis, and 3 with indeterminant colitis). Mothers comprised 80% of parents. The median patient age at enrollment was 14.8 years, and the median interval between diagnosis and enrollment was 1.1 months. Children with anxious parents reported a significantly lower median IMPACT-III score than children with non-anxious parents (135 vs. 122, p=0.002). In contrast, parental depression was not associated with lower childhood QoL scores (127 vs. 129, p=0.795). Parental anxiety or depression was independent of child anxiety (p=0.078) or depression (p=0.678). Healthcare utilization significantly decreased at one-year post-consent. Regardless of IBD diagnosis or disease severity, no difference in healthcare utilization was observed during the study interval. CONCLUSIONS: Parental anxiety correlated with worse QoL in children with newly diagnosed IBD. However, larger longitudinal studies are needed to understand better the relationship between parental anxiety in the first few years following diagnosis. These data will inform future interventions focussed on optimizing the clinical course and quality of life in children and adolescents following a new diagnosis of IBD.
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Attribution 4.0 International