Prevalence and risk factors of depression among patients with perianal fistulizing Crohn’s disease

Table 1 Demographic and clinical characteristics of perianal fistulizing Crohn’s disease patients with and without depression, n (%)

Variable	Cohort, n = 123	Without depression, n = 53	With depression, n = 70	P value
Demographic characteristics
Female sex	38 (30.89)	12 (22.64)	26 (37.14)	0.115
Age in yr	28.55 ± 9.18	28.51 ± 9.17	28.59 ± 9.26	0.964
BMI in kg/m2	21.02 ± 3.85	21.56 ± 3.80	20.60 ± 3.86	0.175
Smoker	9 (7.32)	1 (1.89)	8 (11.43)	0.076
High school or above	86 (69.93)	41 (77.36)	45 (64.29)	0.164
Married	45 (36.59)	20 (37.74)	25 (35.71)	0.852
Procreated	38 (30.89)	15 (28.30)	23 (32.86)	0.694
Currently employed	73 (59.35)	32 (60.38)	41 (58.57)	0.855
Low-income population as ≤ 3.6 million yuan	61 (49.59)	27 (50.94)	34 (48.57)	0.856
Overall clinical characteristics
CD course in yr	4.26 ± 4.70	3.90 ± 4.10	4.53 ± 5.11	0.465
CD phenotypes
L1-Terminal ileum	52 (42.28)	25 (47.17)	27 (38.57)	0.362
L2-Colon	33 (26.83)	16 (30.19)	17 (24.29)	0.539
L3-Ileum and colon	38 (30.89)	12 (22.64)	26 (37.14)	0.115
B2-Stricturing	39 (31.71)	18 (33.96)	21 (30.00)	0.698
B3-Penetrating	3 (2.44)	2 (3.77)	1 (1.43)	0.577
CDAI score, median ± IQR	98.77 ± 119.39	46.67 ± 82.04	130.20 ± 99.21	0.000
History of gastrointestinal surgery	18 (14.63)	6 (11.32)	12 (17.14)	0.445
History of ostomy	8 (6.50)	5 (9.43)	3 (4.29)	0.289
Laboratory indicators, median ± IQR
ESR in mm/h	23.00 ± 29.00	14.00 ± 22.00	34.00 ± 39.00	0.000
CRP in mg/L	7.96 ± 17.80	5.72 ± 11.57	10.20 ± 25.47	0.004
FC in µg/g	732.80 ± 1128.30	374.20 ± 845.00	836.90 ± 1414.95	0.001
Current medication
Biologics therapy	88 (71.54)	35 (66.04)	53 (75.71)	0.313
Immunomodulator therapy	26 (21.14)	8 (15.09)	18 (25.71)	0.184
Corticosteroid therapy	15 (12.20)	5 (9.43)	10 (14.29)	0.580
Perianal clinical characteristics
PFCD course in month, median ± IQR	6.00 ± 23.00	5.00 ± 24.00	7.50 ± 28.00	0.146
History of perianal surgery of ≥ 2	57	24	33	0.857
PDAI score, median ± IQR	6.00 ± 5.00	4.50 ± 5.00	6.00 ± 5.00	0.001
Wexner score, median ± IQR	2.00 ± 7.00	1.00 ± 4.00	4.50 ± 7.00	0.001
Modified Van Assche index, median ± IQR	12.00 ± 8.00	8.00 ± 11.00	13.00 ± 5.00	0.000
Physiological and psychological characteristics
IBDQ score, median ± IQR	172 ± 50	194 ± 27	152 ± 37	0.000
IBD-F score, median ± IQR	6.00 ± 5.00	4.00 ± 5.00	8.00 ± 4.00	0.000

BMI: Body mass index; CD: Crohn’s disease; CDAI: Crohn’s Disease Activity Index; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; FC: Fecal calprotectin; IBD-F: Inflammatory Bowel Disease Fatigue; IBDQ: Inflammatory Bowel Disease Patient Quality of Life Questionnaire; IQR: Interquartile range; PDAI: Perianal Disease Activity Index; PFCD: Perianal fistulizing Crohn’s disease.

Table 2 Prevalence of depression among perianal fistulizing Crohn’s disease patients, n (%)

Clinical characteristic	No depression	Mild depression	Moderate depression	Moderately severe depression	Severe depression
PFCD	53 (43.09)	53 (43.09)	6 (4.88)	8 (6.50)	3 (2.44)

PFCD: Perianal fistulizing Crohn’s disease.

Table 3 Multivariate logistic regression analysis of perianal fistulizing Crohn’s disease patients with depression

Factor	β value	Wald value	P value	OR value	95%CI
Smoker	1.111	0.36	0.550	3.04	0.08 to 116.33
CDAI score	0.000	0.00	0.957	1.00	0.99 to 1.02
ESR in mm/h	0.029	2.20	0.138	1.03	0.99 to 1.07
CRP in mg/L	-0.030	1.28	0.258	0.97	0.92 to 1.02
FC in µg/g	0.001	3.17	0.075	1.00	1.00 to 1.00
PDAI score	-0.373	5.03	0.025	0.69	0.50 to 0.95
Wexner score	0.020	0.04	0.850	1.02	0.83 to 1.26
Modified Van Assche index	0.218	4.37	0.037	1.24	1.01 to 1.53
IBDQ score	-0.076	9.73	0.002	0.93	0.88 to 0.97
IBD-F score	0.545	10.02	0.002	1.72	1.23 to 2.42

CI: Confidence interval; CDAI: Crohn’s Disease Activity Index; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; FC: Fecal calprotectin; IBD-F: Inflammatory Bowel Disease Fatigue; IBDQ: Inflammatory Bowel Disease Patient Quality of Life Questionnaire; OR: Odds ratio; PDAI: Perianal Disease Activity Index.

Table 4 Multiple linear regression analysis of perianal fistulizing Crohn’s disease patients with depression

Factor	β value	t value	P value	95%CI	R2
Smoker	0.124	0.09	0.928	-2.58 to 2.83	0.650
CD activity index	0.006	0.96	0.341	-0.01 to 0.02
ESR in mm/h	0.005	0.25	0.804	-0.03 to 0.04
CRP in mg/L	-0.006	-0.32	0.746	-0.04 to 0.03
FC in µg/g	0.000	0.78	0.440	0.00 to 0.00
PDAI score	-0.134	-1.06	0.292	-0.39 to 0.12
Wexner score	-0.069	-0.88	0.380	-0.23 to 0.09
Modified Van Assche index	0.166	2.22	0.028	0.02 to 0.31
IBDQ score	-0.116	-8.58	0.000	-0.14 to -0.09
IBD-F score	0.169	1.61	0.109	-0.04 to 0.38

CI: Confidence interval; CD: Crohn’s disease; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; FC: Fecal calprotectin; IBD-F: Inflammatory Bowel Disease Fatigue; IBDQ: Inflammatory Bowel Disease Patient Quality of Life Questionnaire; PDAI: Perianal Disease Activity Index.