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Improvement of psychological status after infliximab treatment in patients with newly diagnosed Crohn’s disease

Authors Zhang M, Zhang T, Hong L, Zhang C, Zhou J, Fan R, Wang L, Wang Z, Xu B, Zhong J

Received 13 November 2017

Accepted for publication 21 January 2018

Published 21 May 2018 Volume 2018:12 Pages 879—885

DOI https://doi.org/10.2147/PPA.S156883

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Dr Naifeng Liu


Maochen Zhang,* Tianyu Zhang,* Liwen Hong, Chen Zhang, Jie Zhou, Rong Fan, Lei Wang, Zhengting Wang, Bin Xu, Jie Zhong

Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Background: Patients with newly diagnosed Crohn’s disease (CD) are associated with impaired physical and psychological well-being. These psychological characteristics are dynamic with the course of disease and could be influenced by medical treatment. Infliximab is effective and widely used in moderate-to-severe CD patients. The aim of this study was to evaluate the improvement of psychological status after infliximab treatment in patients with newly diagnosed CD.
Methods: Newly diagnosed moderate-to-severe CD patients were prospectively enrolled in our study. Infliximab 5 mg/kg was administered at weeks 0, 2, 6, 14, 22, and 30. Outcomes including disease severity, illness perceptions, coping strategies, anxiety, depression, and quality of life (QoL) were measured at baseline, week 14, and week 30.
Results: Eighty-two patients completed our study. The rates of clinical remission at weeks 14 and 30 were 59/82 (72.0%) and 58/82 (70.7%), respectively. Patients who achieved clinical remission at weeks 14 and 30 significantly improved in illness perceptions (P<0.001 and <0.001), maladaptive coping (P=0.005 and 0.004), anxiety (P<0.001 and <0.001), depression (P=0.004 and 0.004), and QoL (P<0.001 and <0.001). However, emotion-focused coping and problem-focused coping remained unchanged. For infliximab nonresponders, no significant changes were seen in illness perceptions, coping strategies, anxiety, depression, or QoL at week 14 or 30.
Conclusion: Effective infliximab treatment not only led to clinical remission in patients with newly diagnosed moderate-to-severe CD but also improved their psychological status including illness perceptions, maladaptive coping, anxiety, depression, and QoL.

Keywords:
illness perceptions, coping strategies, anxiety and depression, quality of life, infliximab

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