Treatment Adherence in Adolescents With Inflammatory Bowel Disease: The Collective Impact of Barriers to Adherence and Anxiety/Depressive Symptoms

Gray, W. N.; Denson, L. A.; Baldassano, R. N.; Hommel, K. A.

doi:10.1093/jpepsy/jsr092

Cited by 143Medication Adherence and ComplianceAdolescent and Pediatric HealthcareInflammatory Bowel Disease

Treatment Adherence in Adolescents With Inflammatory Bowel Disease: The Collective Impact of Barriers to Adherence and Anxiety/Depressive Symptoms

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Gray, W. N., Denson, L. A., Baldassano, R. N., Hommel, K. A.·2012·Journal of Pediatric Psychology

DOI 10.1093/jpepsy/jsr092PMC PMC3306169

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Abstract

OBJECTIVE: Knowledge of factors impacting adolescents' ability to adhere to their inflammatory bowel disease (IBD) regimen is limited. The current study examines the collective impact of barriers to adherence and anxiety/depressive symptoms on adolescent adherence to the IBD regimen. METHODS: Adolescents (n = 79) completed measures of barriers to adherence, adherence, and anxiety/depressive symptoms at one of two specialty pediatric IBD clinics. RESULTS: Most adolescents reported barriers to adherence and 1 in 8 reported borderline or clinically elevated levels of anxiety/depressive symptoms. Anxiety/depressive symptoms moderated the relationship between barriers to adherence and adherence. Post hoc probing revealed a significant, additive effect of higher anxiety/depressive symptoms in the barriers-adherence relationship, with adherence significantly lower among adolescents with higher barriers and higher anxiety/depressive symptoms. CONCLUSIONS: In order to optimize adherence in adolescents, interventions should target not only barriers to adherence but also any anxiety/depressive symptoms that may negatively impact efforts to adhere to recommended treatment.

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Comorbid psychological difficulties in IBD are associated with disease activity, flares, treatment response, and the necessity of surgical intervention.
“Indeed, comorbid psychological difficulties are associated with disease activity, flares, treatment response, and the necessity of surgical intervention [2,6,8,9,10,11,12,13,14,15].”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [11]
The Introduction says emotional problems can exacerbate IBD disease activity, supporting that part of the claim. The Moderator Analysis links anxiety/depressive symptoms to poorer treatment adherence when barriers increase, not to treatment response. The passages do not establish associations with flares or the need for surgery; the Disease Activity section mentions surgery only when describing an assessment scale. (LLM, conf=0.88)
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Authors: Gray, W. N., Denson, L. A., Baldassano, R. N., & Hommel, K. A.
Affiliations: Cincinnati Children's Hospital Medical Center (US)
ORCID: Denson, L. A.
Baldassano, R. N.
Hommel, K. A.
Venue: Journal of Pediatric Psychology
Publisher: Oxford University Press (OUP)
Published: 2011-11-10
Volume: 37
Issue: 3
Pages: 282-291
ISSN: 0146-8693 (ISSN-L)
1465-735X
DOI: 10.1093/jpepsy/jsr092
PMC: PMC3306169
OpenAlex: W2142245641
Cited by: 143
References: 53
Citations by year: 2026: 2 · 2025: 4 · 2024: 7 · 2023: 16 · 2022: 9 · 2021: 14 · 2020: 12 · 2019: 9 · 2018: 11 · 2017: 13 · 2016: 10 · 2015: 10 · 2014: 10 · 2013: 13 · 2012: 3
FWCI: 7.65
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of Pediatric Psychology (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Procter and Gamble
National Institutes of Health (5ul1rr026314-03, UL1TR000077, 1UL1RR026314)
National Institute of Diabetes and Digestive and Kidney Diseases (K23DK079037)
National Center for Research Resources (1UL1RR026314, UL1-RR026314)
National Center for Advancing Translational Sciences
Topics: Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
Keywords: inflammatory bowel disease, adolescents, medication adherence, barriers to adherence, anxiety symptoms, depressive symptoms, psychosocial factors, pediatric inflammatory bowel disease
MeSH terms: Adolescent, Adolescent Behavior, Anxiety, Colitis, Ulcerative, Crohn Disease, Depression, Female, Humans, Male, Severity of Illness Index, Inflammatory Bowel Diseases, Medication Adherence, Checklist

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Treatment Adherence in Adolescents With Inflammatory Bowel Disease: The Collective Impact of Barriers to Adherence and Anxiety/Depressive Symptoms

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