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Even Mild Inflammatory Bowel Disease Adversely Affects Psychosocial Functioning of Children and Families: Presented at DDW

By Ed Susman

ORLANDO, FL -- May 23, 2003 -- The social and family functioning of children with even mild inflammatory bowel disease (IBD) are adversely affected by the disease, noted researchers here at a May 20^th poster presentation during Digestive Disease Week 2003.
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Wallace Crandall, MD, clinical assistant professor of pediatrics, Ohio State University, in Columbus, said that having identified the emotional distress that continues to trouble children and their families a year after diagnosis, researchers are now planning studies to determine whether counseling and/or intervention with anti-depressants or anti-anxiolytics might help the children.

"We know from studies in adults that you can change disease course with psychosocial interventions," said Dr. Wallace. "And we found that children with mild IBD may be at greater risk for attention problems, anxiety and depression symptoms, social problems, and school absences than healthy children, even a year or more after diagnosis. These difficulties reach clinical significance for only a subset of children," he added.

As part of an ongoing study, Dr. Wallace and colleagues recruited 31 children with IBD and a control group of 27 healthy children. All of the children were between the ages of 11 and 17. They completed the validated psychological instrument, the Piers Harris Self-Concept Scale and Body Esteem Scale.

Parents completed a demographic questionnaire, Child Behaviour Checklist, and Family Assessment Device. The children's teachers completed the Teacher Report Form. Grades and absences were obtained from school records. For the children with IBD, each child's gastroenterologist completed a Paediatric Crohn's Disease Activity Index within a week after completion of the questionnaires.

The researchers found that parents of children with IBD reported that their children had significantly more attention problems (P=.034) and anxious/depressed symptoms (P=.049) than parents of healthy children, with 17% reporting attention problems that reached clinical significance and 10% reporting clinically significant anxious/depressed symptoms, compared to 4% of healthy children on each scale.

In school functioning, there were no significant differences in grade-point average, participation in special education, or repeating a grade, although children with IBD had significantly more absences than healthy children (P=.019). Teachers of children with IBD reported significantly more attention problems (P=.025), with 8% reaching clinical significance compared to 0% of healthy children.

Parents of children with IBD reported significantly more social problems than healthy children (P=.008), with 17% reporting clinically significant problems compared to none of the parents of healthy children.

There were no significant differences in family functioning, body image or self-esteem.

Dr. Wallace concluded that children with IBD do have some problems that must be addressed.


[Study title: Psychosocial Outcomes In Mild Pediatric Inflammatory Bowel Disease. Abstract 103703

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