Jordi, Sebastian Bruno Ulrich; Botte, Federica; Lang, Brian Matthew; Greuter, Thomas; Krupka, Niklas; Auschra, Bianca; Schreiner, Philipp; Sulz, Michael Christian; Biedermann, Luc; von Känel, Roland; Rogler, Gerhard; Begré, Stefan; Misselwitz, Benjamin (2021). Type D personality is associated with depressive symptoms and clinical activity in inflammatory bowel disease. Alimentary pharmacology & therapeutics, 54(1), pp. 53-67. Wiley-Blackwell 10.1111/apt.16365
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BACKGROUND
Inflammatory bowel disease (IBD) can be exacerbated by stress and depression. Type D personality, characterised by high negative affectivity and social inhibition, represents a vulnerability towards stressors and is associated with adverse outcomes in coronary heart disease.
AIMS
To assess the prevalence of Type D personality in IBD patients and investigate potential associations with disease course.
METHODS
We tested for associations between Type D (Type D Scale-14), depressive symptoms (Hospital Anxiety and Depression Scale's depression subscore ≥11) and recurrent IBD amongst Swiss IBD cohort patients. We built regression models for cross-sectional and Cox proportional hazards models for time-to-event analyses. IBD disease course was assessed by the future occurrence of active disease (Crohn's Disease Activity Index ≥150/Modified Truelove & Witts activity index ≥10) and several IBD-relevant endpoints.
RESULTS
Amongst 2275 patients (1005 ulcerative colitis, 1270 Crohn's disease), 672 (29.5%) had Type D. Type D was a significant risk factor for future active disease (adjusted hazard ratio, aHR: 1.60, corrected P value, q = 0.007) and predicted the future presence of depressive symptoms (aHR: 3.30, P < 0.001). The combination of Type D and depressive symptoms further increased the risk for active disease (aHR: 3.98, q < 0.001). However, Type D associated depressive symptoms seemed to be the main contributor to this effect as Type D's predictive power decreased considerably in models corrected for depressive symptoms (aHR: 1.32, CI: 0.97-1.79, q = 0.292).
CONCLUSIONS
Type D personality's prevalence amongst IBD patients was comparable with its prevalence in the general population. Type D was strongly associated with depressive symptoms and showed modest independent associations with IBD prognosis.
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