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Cited by 34Inflammatory Bowel DiseaseAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and Applications

Effect of 2 Psychotherapies on Depression and Disease Activity in Pediatric Crohnʼs Disease

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Szigethy, Eva, Youk, Ada O., Gonzalez-Heydrich, Joseph, Bujoreanu, Simona I., Weisz, John, Fairclough, Diane, Ducharme, Peter, Jones, Neil +6 more·2015·Inflammatory Bowel Diseases
DOI 10.1097/mib.0000000000000358PMC PMC4437807
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Abstract

BACKGROUND: Crohn's disease (CD) is associated with depression. It is unclear if psychosocial interventions offer benefit for depressive symptoms during active CD. In this secondary analysis of a larger study of treating depression in pediatric inflammatory bowel disease, we assessed whether cognitive behavioral therapy (CBT) would differentiate from supportive nondirective therapy in treating depression and disease activity in youth with CD. We also explored whether somatic depressive symptoms showed a different pattern of response in the overall sample and the subset with active inflammatory bowel disease. METHODS: Youth with depression and CD (n = 161) were randomized to 3 months of CBT (teaching coping skills) or supportive nondirective therapy (supportive listening). Depressive severity was measured using the Children's Depression Rating Scale-Revised (CDRS-R) with the somatic depressive subtype consisting of those CDRS-R items, which significantly correlated with CD activity. Disease activity was measured by the Pediatric Crohn's disease Activity Index. Given the potential confound of higher dose steroids, subanalyses excluded subjects on >20 mg/d prednisone equivalent (n = 34). RESULTS: Total CDRS-R scores in the overall sample significantly decreased over time after both treatments (P < 0.0001). Treatment with CBT was associated with a significantly greater improvement in the Pediatric Crohn's disease Activity Index (P = 0.05) and somatic depressive subtype (P = 0.03) in those with active inflammatory bowel disease (n = 95) compared with supportive nondirective therapy. After excluding those on steroids (n = 34), there was a significant improvement in total CDRS-R (P = 0.03) and in Pediatric Crohn's disease Activity Index (P = 0.03) after CBT. CONCLUSIONS: Psychotherapy may be a useful adjunct to treat depression in the context of CD-related inflammation in youth who are not concurrently on higher dose steroids.

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  • In a trial for participants with depression, Szigethy et al. 2014 found an improvement in both the CBT and SNDT groups but there were no differences between the groups in change over time and the trial did not include a usual care control group.

    “In a trial for participants with depression, Szigethy et al. 2014 found an improvement in both the CBT and SNDT groups but there were no differences between the groups in change over time and the trial did not include a usual care control group 29,33 .”

    From A Systematic review of self-management interventions for children and adolescents with inflammatory bowel disease (2019) · cites this paper as [33]

  • No significant differences were found between treatments in HRQoL.

    “but no significant differences were found between treatments.”

    From A Systematic review of self-management interventions for children and adolescents with inflammatory bowel disease (2019) · cites this paper as Szigethy et al (2015)

  • No significant difference between interventions on Children's Global Assessment Scale.

    “No significant difference between interventions.”

    From A Systematic review of self-management interventions for children and adolescents with inflammatory bowel disease (2019) · cites this paper as Szigethy et al (2015)

    The Results section reports no significant difference between CBT and SNDT on the Children's Depression Rating Scale–Revised (CDRS-R), not on the Children's Global Assessment Scale. The Measures and Statistical Analyses sections do not identify the Children's Global Assessment Scale as an outcome. Searches for that scale and CGAS found no passage reporting an intervention comparison on it. (LLM, conf=0.74)

    Experimental — accuracy not yet measured

  • Both therapies showed an improvement in HRQoL.

    “Both therapies showed an improvement in HRQoL”

    From A Systematic review of self-management interventions for children and adolescents with inflammatory bowel disease (2019) · cites this paper as Szigethy et al (2015)

    The Results section reports that both therapies improved depressive severity and disease activity, but it does not report an HRQoL outcome. The Design section mentions quality of life as an outcome of the parent trial; a search for HRQoL and quality-of-life improvement found no result for either therapy in this paper. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • Mean CGAS scores posttreatment (CBT 65.83 versus SNDT 64.30) were consistent with minimal impairment on the CGAS scale.

    “Mean CGAS scores posttreatment, (CBT 65.83 versus SNDT 64.30) were consistent with minimal impairment on the CGAS scale.”

    From A Systematic review of self-management interventions for children and adolescents with inflammatory bowel disease (2019) · cites this paper as Szigethy et al (2015)

    The Measures section describes CDRS-R and PCDAI, and the Results section reports changes in those outcomes, but neither provides posttreatment CGAS scores or a CGAS impairment category. Searches for CGAS, “minimal impairment,” 65.83, and 64.30 found no passage addressing the claim. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

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Authors
Szigethy, E., Youk, A. O., Gonzalez-Heydrich, J., Bujoreanu, S. I., Weisz, J., Fairclough, D., Ducharme, P., Jones, N., Lotrich, F., Keljo, D., Srinath, A., Bousvaros, A., Kupfer, D., & DeMaso, D. R.
Affiliations
  • Boston Children's Hospital (US)
  • University of Pittsburgh (US)
  • Harvard University (US)
  • Colorado School of Public Health (US)
  • Children's Hospital of Pittsburgh (US)
Corresponding author
  • Szigethy, Eva
  • Weisz, John
ORCID
Venue
Inflammatory Bowel Diseases
Publisher
Oxford University Press (OUP)
Published
2015-03
Volume
21
Issue
6
Pages
1
ISSN
1078-0998 (ISSN-L)
DOI
10.1097/mib.0000000000000358
PMC
PMC4437807
OpenAlex
W2153411648
Cited by
34
References
8
Citations by year
2025: 2 · 2024: 1 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 4 · 2018: 4 · 2017: 7 · 2016: 7 · 2015: 2
FWCI
4.58
Type
journal article
Language
en
Open access
Locations
  • Inflammatory Bowel Diseases (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
  • Crohn's and Colitis Foundation of America
  • Abbott Laboratories
  • Pfizer
  • GlaxoSmithKline
  • Tommy Fuss Fund
  • Crohn's and Colitis Foundation
  • AkzoNobel
  • Servier
  • National Institutes of Health (UL1TR000005, DP2OD001210)
  • National Institute of Mental Health (R01MH077770, R01 MH07770)
  • National Center for Advancing Translational Sciences
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
pediatric Crohn's disease, depression
MeSH terms
Adaptation, Psychological, Adolescent, Adrenal Cortex Hormones, Child, Crohn Disease, Depressive Disorder, Female, Humans, Male, Psychiatric Status Rating Scales, Psychotherapy, Severity of Illness Index, Social Support, Cognitive Behavioral Therapy

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