Brief Article
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World J Gastroenterol. Mar 14, 2013; 19(10): 1611-1617
Published online Mar 14, 2013. doi: 10.3748/wjg.v19.i10.1611
Cognitive functioning and depressive symptoms in adolescents with inflammatory bowel disease
Anu E Castaneda, Annamari Tuulio-Henriksson, Eeva T Aronen, Mauri Marttunen, Kaija-Leena Kolho
Anu E Castaneda, Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00271 Helsinki, Finland
Annamari Tuulio-Henriksson, Research Department, Social Insurance Institute, 00250 Helsinki, Finland
Eeva T Aronen, Child Psychiatry, Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, 00250 Helsinki, Finland
Mauri Marttunen, Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Central Hospital, 00271 Helsinki, Finland
Mauri Marttunen, Department of Mental Health and Substance Use Services, National Institute for Health and Welfare, 00271 Helsinki, Finland
Kaija-Leena Kolho, Hospital for Children and Adolescents, Department of Pediatric Gastroenterology, University of Helsinki, 00250 Helsinki, Finland
Author contributions: Castaneda AE performed the statistical analyses and wrote the first draft and the final version of the manuscript; Tuulio-Henriksson A contributed methodological and neuropsychological expertise; Aronen ET and Marttunen M contributed psychiatric expertise on studies in adolescents; Kolho KL brought the original idea of the study, contributed expertise on adolescent inflammatory bowel disease and was in charge of the clinical evaluation of the patients; all authors contributed to designing the study protocol and manuscript writing and approved the final version of the manuscript.
Supported by Foundation of Päivikki and Sakari Sohlberg, the Emil Aaltonen Foundation, the Foundation for Pediatric Research, the Helsinki University Central Hospital Research Fund, and the Academy of Finland
Correspondence to: Anu E Castaneda, PhD, Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 166, Helsinki PO Box 30, 00271 Helsinki, Finland. anu.castaneda@thl.fi
Telephone: +358-29-5248597 Fax: +358-29-5248478
Received: October 15, 2012
Revised: December 12, 2012
Accepted: December 15, 2012
Published online: March 14, 2013
Processing time: 150 Days and 1 Hours
Abstract

AIM: To investigate cognitive functioning and depressive symptoms in adolescents with inflammatory bowel disease (IBD).

METHODS: A neuropsychological test battery, including subtests of the Wechsler Adult Intelligence Scale-Revised and III, Wechsler Memory Scale-Revised, California Verbal Learning Test (CVLT), Stroop Color-Word Test, and Trail Making Test, which assessed verbal and visual short- and long-term memory, processing speed, logical reasoning, verbal intelligence, attention, and executive functioning, was administered to 13- to 19-year-old patients with IBD (n = 34; active disease n = 20). Depressive symptoms were measured with the Beck Depression Inventory. The findings were compared with peers with non-acute juvenile idiopathic arthritis (JIA; n = 23). Patients with coexisting psychiatric disorders were excluded.

RESULTS: The IBD group, especially patients in the acute phase, made more perseverative errors in the CVLT test that assessed verbal memory than the JIA group (6.0 ± 4.3 vs 3.3 ± 2.9, P < 0.01), but no other differences between the IBD and JIA groups were observed in the neuropsychological tests. The difference was close to statistical significance, even when glucocorticoid medication was controlled for (P < 0.052). The IBD group had more depressive symptoms than the JIA group (7.9 ± 7.6 vs 4.0 ± 4.0, P < 0.05). Approximately one third of the IBD group had at least mild depressive symptoms, and those with acute illness had the highest scores. However, depressive symptoms were not related to the difference in the verbal memory test (perseverative errors in the CVLT) between the IBD and JIA groups.

CONCLUSION: Adolescents with acute IBD may have mild verbal memory problems but no major cognitive deficits compared to peers with JIA.

Keywords: Cognitive impairment; Inflammatory bowel disease; Crohn’s disease; Depressive symptoms; Ulcerative colitis; Adolescents