Subjective Psychophysical Experiences in the Course of Inflammatory Bowel Disease—A Comparative Analysis Based on the Polish Pediatric Crohn’s and Colitis Cohort (POCOCO)
Abstract
:1. Introduction
2. Materials and Methods
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences;
- The Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics; The Children’s Memorial Health Institute, Warsaw;
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw;
- Department and Clinic of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University;
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice;
- Department of Pediatrics, Faculty of Medical Sciences, Medical University of Silesia in Katowice;
- Department of Pediatric Endoscopy and Gastrointestinal Function Testing, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz.
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables Median (IQR) or n (%) | Crohn’s Disease n = 196 | Ulcerative Colitis n = 180 | p-Value |
---|---|---|---|
Age [years] | |||
at inclusion | 15.0 (13.2–17.0) | 15.2 (11.7–16.8) | 0.0774 |
at diagnosis | 12.4 (9.8–14.6) | 12.1 (8.1–14.9) | 0.4520 |
at worst flare | 13.6 (11.5–15.9) | 13.8 (10.2–15.9) | 0.3694 |
Duration of the disease (years) | 2.2 (0.7–4.2) | 1.7 (0.4–3.7) | 0.2430 |
Sex | 75 (38.3) females | 80 (44.4) females | 0.2491 |
Nutritional status | |||
Weight at diagnosis (kg) | 38.8 (27.0–51.0) | 40.0 (28.8–54.0) | 0.5455 |
Weight at diagnosis (z score) | −0.81 ([−1.38]–0.00) | −0.52 ([−1.14]–0.22) | 0.0106 |
Height at diagnosis (cm) | 150.5 (136.0–166.0) | 151.5 (131.0–168.5) | 0.7550 |
Height at diagnosis (z score) | −0.30 ([−1.20]–0.51) | 0.11 ([−0.67]–0.86) | 0.0042 |
Body mass index at diagnosis (kg/m2) | 16.6 (14.6–18.4) | 17.3 (15.5–19.1) | 0.0407 |
Body mass index at diagnosis (z score) | −0.79 ([−1.45]–[−0.03]) | −0.49 ([−1.02]–0.14) | 0.0169 |
Albumin level at diagnosis (g/dL) | 3.9 (3.5–4.3) | 4.1 (3.7–4.41) | 0.0028 |
Parameter of inflammation | |||
CRP at diagnosis (mg/L) | 12.9 (2.0–30.3) | 2.1 (0.5–9.5) | <0.0001 |
CRP at worst flare (mg/L) | 13.0 (3.0–35.0) | 2.7 (0.6–13.4) | <0.0001 |
Disease activity scales | |||
PCDAI/PUCAI at diagnosis | 30 (23–48) | 38 (30–53) | * |
PCDAI/PUCAI at worst flare | 40 (30–53) | 56 (38–75) | * |
Treatment | |||
Systemic glucocorticosteroids ** | 107 (54.6) | 129 (71.7) | 0.0007 |
Immunosuppressive treatment *** | 153 (78.1) | 103 (57.5) | <0.0001 |
Biological therapy **** | 98 (50.0) | 46 (25.6) | <0.0001 |
Operative treatment ***** | 24 (12.2) | 3 (1.7) | <0.0001 |
Subjective psychophysical experiences at recruitment | |||
Pain | 1 (0–2) | 1 (0–3) | 0.1528 |
Anxiety | 2 (0–3) | 2 (1–5) | 0.0210 |
Limitations at school/preschool activities | 1 (0–4) | 2 (0–6) | 0.0235 |
Limitations in peer relationships | 0 (0–3) | 1 (0–5) | 0.0731 |
Pain | p-Value | Anxiety | p-Value | Limitations in Peer Relationships | p-Value | Limitations in School Activities | p-Value | |
---|---|---|---|---|---|---|---|---|
IBD | ||||||||
UC | 6 (4–8) | 0.637 | 5 (3–8) | 0.162 | 3 (0–7) | 0.472 | 5 (3–8) | 0.348 |
CD | 6 (4–8) | 5 (2–7) | 3 (0–6) | 5 (2–8) | ||||
Systemic glucocorticosteroids | ||||||||
Yes | 7 (4–8) | 0.002 | 5 (3–8) | 0.105 | 4 (1–7) | 0.004 | 5 (3–8) | 0.057 |
No | 6 (3–7) | 5 (2–7) | 2 (0–5) | 4 (1–8) | ||||
Immunosuppressive treatment | ||||||||
Yes | 7 (4–8) | <0.001 | 5 (3–8) | 0.009 | 4 (1–7) | <0.001 | 5 (3–8) | 0.103 |
No | 5 (2–7) | 4 (2–6) | 2 (0–5) | 4 (1–8) | ||||
Biological therapy | ||||||||
Yes | 7 (4–8) | 0.015 | 5 (2–8) | 0.533 | 4 (1–7) | 0.007 | 5 (2–9) | 0.055 |
No | 6 (3–8) | 5 (3–7) | 3 (0–5) | 4 (2–8) | ||||
Surgery * | ||||||||
Yes | 6 (4–7) | 0.291 | 5 (3–6) | 0.373 | 4 (1–6) | 0.536 | 6 (3–10) | 0.147 |
No | 6 (4–8) | 5 (3–8) | 3 (0–6) | 5 (2–8) |
Pain | p-Value | Anxiety | p-Value | Limitations in Peer Relationships | p-Value | Limitations in School Activities | p-Value | |
---|---|---|---|---|---|---|---|---|
IBD | ||||||||
UC | 8 (6–9) | 0.661 | 7 (4–9) | 0.095 | 5 (2–8) | 0.556 | 8 (4–10) | 0.091 |
CD | 8 (5–9) | 6 (4–8) | 5 (1–8) | 6 (3–9) | ||||
Systemic glucocorticosteroids | ||||||||
Yes | 8 (6–10) | <0.001 | 7 (5–9) | 0.015 | 6 (2–9) | 0.016 | 8 (4–10) | 0.005 |
No | 8 (5–9) | 6 (3–8) | 4 (1–8) | 6 (2–9) | ||||
Immunosuppressive treatment | ||||||||
Yes | 8 (6–10) | <0.001 | 7 (5–9) | 0.031 | 6 (2–8) | 0.003 | 8 (4–10) | 0.003 |
No | 8 (4–9) | 6 (3–8) | 3 (0–8) | 6 (1–9) | ||||
Biological therapy | ||||||||
Yes | 9 (7–10) | 4 × 10−5 | 7 (5–9) | 0.005 | 7 (2–9) | <0.001 | 9 (5–10) | 0.019 |
No | 8 (5–9) | 6 (4–8) | 4 (1–8) | 6 (2–9) | ||||
Surgery * | ||||||||
Yes | 8 (7–10) | 0.610 | 7 (5–8) | 0.532 | 7 (4–9) | 0.083 | 9 (4–10) | 0.185 |
No | 8 (6–9) | 7 (4–8) | 5 (1–8) | 7 (3-10) |
Subjective Psychophysical Experiences | Treatment Parameter | p-Value | rho |
---|---|---|---|
Pain at diagnosis 1 | Number of glucocorticosteroid courses | 0.0005 | 0.18 |
Number of immunosuppressants | 0.0011 | 0.17 | |
Age at first immunosuppression | 0.0146 | −0.15 | |
Number of biological agents | 0.0100 | 0.13 | |
Pain at the worst flare 2 | Number of glucocorticosteroid courses | 0.0131 | 0.22 |
Number of immunosuppressants | 0.0005 | 0.18 | |
Number of biological agents | 0.0229 | 0.21 | |
Anxiety at diagnosis 3 | Number of glucocorticosteroid courses | 0.0392 | 0.11 |
Number of immunosuppressants | 0.0142 | 0.13 | |
Age at first immunosuppression | 0.0268 | −0.14 | |
Anxiety at the worst flare 4 | Number of immunosuppressants | 0.0220 | 0.23 |
Age at first immunosuppression | 0.0085 | −0.17 | |
Number of biological agents | 0.0070 | 0.14 | |
Limitations in peer relationships at diagnosis 5 | Number of glucocorticosteroid courses | 0.0002 | 0.20 |
Number of immunosuppressants | 0.0002 | 0.19 | |
Time to first immunosuppression | 0.0455 | −0.13 | |
Age at first immunosuppression | 0.0238 | −0.14 | |
Number of biological agents | 0.0087 | 0.14 | |
Limitations in peer relationships at the worst flare 6 | Number of glucocorticosteroid courses | 0.0220 | 0.23 |
Number of biological agents | 0.0005 | 0.18 | |
Age at first biological treatment | 0.0271 | −0.19 | |
Limitations in school activities at diagnosis 7 | Number of glucocorticosteroid courses | 0.0100 | 0.13 |
Number of immunosuppressants | 0.0360 | 0.11 | |
Number of biological agents | 0.0494 | 0.10 | |
Limitations in school activities at the worst flare 8 | Number of glucocorticosteroid courses | 0.0026 | 0.26 |
Number of immunosuppressants | 0.0433 | 0.21 | |
Age at first immunosuppression | 0.0247 | −0.14 | |
Number of biological agents | 0.0143 | 0.23 | |
Age at first biological treatment | 0.0281 | −0.19 |
Subjective Psychophysical Experiences | Severity Parameter Per 1 Year of The Disease | p-Value | rho |
---|---|---|---|
Pain at diagnosis | Hospitalisations for relapse | 0.3182 | 0.07 |
Days of hospitalisation for relapse | 0.4678 | 0.05 | |
Relapses from diagnosis | 0.0671 | 0.13 | |
Severe relapses from diagnosis | 0.1278 | 0.11 | |
Pain at the worst flare | Hospitalisations for relapse | 0.0510 | 0.13 |
Days of hospitalisation for relapse | 0.0243 | 0.15 | |
Relapses from diagnosis | 0.0013 | 0.22 | |
Severe relapses from diagnosis | 0.0123 | 0.17 | |
Anxiety at diagnosis | Hospitalisations for relapse | 0.9622 | 0.00 |
Days of hospitalisation for relapse | 0.8922 | –0.01 | |
Relapses from diagnosis | 0.8685 | –0.01 | |
Severe relapses from diagnosis | 0.4897 | 0.05 | |
Anxiety at the worst flare | Hospitalisations for relapse | 0.3447 | 0.06 |
Days of hospitalisation for relapse | 0.0412 | 0.14 | |
Relapses from diagnosis | 0.1706 | 0.09 | |
Severe relapses from diagnosis | 0.0097 | 0.18 | |
Limitations in peer relationships at diagnosis | Hospitalisations for relapse | 0.0327 | 0.27 |
Days of hospitalisation for relapse | 0.0047 | 0.32 | |
Relapses from diagnosis | 0.0001 | 0.26 | |
Severe relapses from diagnosis | 0.0016 | 0.22 | |
Limitations in peer relationships at the worst flare | Hospitalisations for relapse | 0.0254 | 0.28 |
Days of hospitalisation for relapse | 0.0019 | 0.35 | |
Relapses from diagnosis | 0.0129 | 0.29 | |
Severe relapses from diagnosis | 0.0048 | 0.19 | |
Limitations in school activities at diagnosis | Hospitalisations for relapse | 0.0172 | 0.28 |
Days of hospitalisation for relapse | 0.0165 | 0.30 | |
Relapses from diagnosis | 0.0002 | 0.25 | |
Severe relapses from diagnosis | 0.0657 | 0.13 | |
Limitations in school activities at the worst flare | Hospitalisations for relapse | 0.0049 | 0.33 |
Days of hospitalisation for relapse | 0.0004 | 0.39 | |
Relapses from diagnosis | 0.0012 | 0.37 | |
Severe relapses from diagnosis | 0.0078 | 0.30 |
Subjective Psychophysical Experiences | Disease Activity Scale | p-Value | rho |
---|---|---|---|
Pain at diagnosis | PCDAI at worst flare | 0.0003 | 0.28 |
Pain at worst flare | PCDAI at worst flare | 0.0159 | 0.19 |
Limitations in peer relationships at diagnosis | PCDAI at diagnosis | 0.0213 | 0.17 |
PCDAI at worst flare | 0.0109 | 0.20 | |
Limitations in school activities at diagnosis | PCDAI at worst flare | 0.0373 | 0.17 |
Limitations in school activities at worst flare | PCDAI at worst flare | 0.0052 | 0.22 |
Pain at diagnosis | PUCAI at worst flare | 0.0160 | 0.20 |
Pain at the worst flare | PUCAI at diagnosis | 0.0122 | 0.20 |
PUCAI at worst flare | 0.0278 | 0.33 | |
Anxiety at the worst flare | PUCAI at diagnosis | 0.0210 | 0.18 |
PUCAI at worst flare | 0.0433 | 0.32 | |
Limitations in peer relationships at diagnosis | PUCAI at diagnosis | 0.0048 | 0.22 |
PUCAI at worst flare | 0.0425 | 0.17 | |
Limitations in peer relationships at the worst flare | PUCAI at diagnosis | 0.0137 | 0.19 |
PUCAI at worst flare | 0.0263 | 0.18 | |
Limitations in school activities at diagnosis | PUCAI at diagnosis | 0.0373 | 0.17 |
Limitations in school activities at the worst flare | PUCAI at diagnosis | 0.0007 | 0.27 |
PUCAI at worst flare | 0.0001 | 0.31 |
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Glapa-Nowak, A.; Bukowska-Posadzy, A.; Szczepanik, M.; Kwiecień, J.; Szaflarska-Popławska, A.; Iwańczak, B.; Flak-Wancerz, A.; Dembiński, Ł.; Osiecki, M.; Kierkuś, J.; et al. Subjective Psychophysical Experiences in the Course of Inflammatory Bowel Disease—A Comparative Analysis Based on the Polish Pediatric Crohn’s and Colitis Cohort (POCOCO). Int. J. Environ. Res. Public Health 2021, 18, 784. https://doi.org/10.3390/ijerph18020784
Glapa-Nowak A, Bukowska-Posadzy A, Szczepanik M, Kwiecień J, Szaflarska-Popławska A, Iwańczak B, Flak-Wancerz A, Dembiński Ł, Osiecki M, Kierkuś J, et al. Subjective Psychophysical Experiences in the Course of Inflammatory Bowel Disease—A Comparative Analysis Based on the Polish Pediatric Crohn’s and Colitis Cohort (POCOCO). International Journal of Environmental Research and Public Health. 2021; 18(2):784. https://doi.org/10.3390/ijerph18020784
Chicago/Turabian StyleGlapa-Nowak, Aleksandra, Anna Bukowska-Posadzy, Mariusz Szczepanik, Jarosław Kwiecień, Anna Szaflarska-Popławska, Barbara Iwańczak, Anna Flak-Wancerz, Łukasz Dembiński, Marcin Osiecki, Jarosław Kierkuś, and et al. 2021. "Subjective Psychophysical Experiences in the Course of Inflammatory Bowel Disease—A Comparative Analysis Based on the Polish Pediatric Crohn’s and Colitis Cohort (POCOCO)" International Journal of Environmental Research and Public Health 18, no. 2: 784. https://doi.org/10.3390/ijerph18020784