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Rate of Corticosteroid-Induced Mood Changes in Patients with Inflammatory Bowel Disease: A Prospective Study

BACKGROUND: Corticosteroid is an effective therapeutic option for inflammatory bowel disease flares, but its adverse effects may compromise treatment adherence and reduce patients’ quality of life. There is lack of data on the incidence of corticosteroid-induced mood changes in this patient populati...

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Autores principales: Ou, George, Bressler, Brian, Galorport, Cherry, Lam, Eric, Ko, Hin Hin, Enns, Robert, Telford, Jennifer, Schaffer, Nathan, Lee, Terry, Rosenfeld, Greg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6507281/
https://www.ncbi.nlm.nih.gov/pubmed/31294728
http://dx.doi.org/10.1093/jcag/gwy023
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author Ou, George
Bressler, Brian
Galorport, Cherry
Lam, Eric
Ko, Hin Hin
Enns, Robert
Telford, Jennifer
Schaffer, Nathan
Lee, Terry
Rosenfeld, Greg
author_facet Ou, George
Bressler, Brian
Galorport, Cherry
Lam, Eric
Ko, Hin Hin
Enns, Robert
Telford, Jennifer
Schaffer, Nathan
Lee, Terry
Rosenfeld, Greg
author_sort Ou, George
collection PubMed
description BACKGROUND: Corticosteroid is an effective therapeutic option for inflammatory bowel disease flares, but its adverse effects may compromise treatment adherence and reduce patients’ quality of life. There is lack of data on the incidence of corticosteroid-induced mood changes in this patient population, which may be underappreciated by healthcare providers in clinical practice and interfere with optimal care. This study aimed to determine the rate of mood changes in this patient population. METHODS: In this prospective observational study, adult outpatients treated with prednisone for inflammatory bowel disease flares were considered for inclusion. Participants completed validated questionnaires (Beck Depression Inventory-II and Activation Subscale of Internal State Scale version two) before starting prednisone, after two weeks of prednisone, and at the end of prednisone taper to assess for mood changes. Harvey-Bradshaw Index and Simple Clinical Colitis Activity Index were used to monitor clinical disease activity. RESULTS: Fifty-three subjects were included in the analyses. The rate of mood change after two weeks of prednisone was 49.1%, primarily driven by increase in mood towards (hypo)mania. Younger age was an independent risk factor. Mood state returned to pretreatment level at the end of treatment. There was no correlation between clinical disease activity change and mood change. CONCLUSIONS: Oral prednisone for inflammatory bowel disease flare is associated with high rate of mood change. As prednisone is a critical part of induction therapy, ways to minimize this adverse event must be studied. For now, healthcare providers should inform patients and monitor closely for this adverse event.
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spelling pubmed-65072812019-07-10 Rate of Corticosteroid-Induced Mood Changes in Patients with Inflammatory Bowel Disease: A Prospective Study Ou, George Bressler, Brian Galorport, Cherry Lam, Eric Ko, Hin Hin Enns, Robert Telford, Jennifer Schaffer, Nathan Lee, Terry Rosenfeld, Greg J Can Assoc Gastroenterol Original Articles BACKGROUND: Corticosteroid is an effective therapeutic option for inflammatory bowel disease flares, but its adverse effects may compromise treatment adherence and reduce patients’ quality of life. There is lack of data on the incidence of corticosteroid-induced mood changes in this patient population, which may be underappreciated by healthcare providers in clinical practice and interfere with optimal care. This study aimed to determine the rate of mood changes in this patient population. METHODS: In this prospective observational study, adult outpatients treated with prednisone for inflammatory bowel disease flares were considered for inclusion. Participants completed validated questionnaires (Beck Depression Inventory-II and Activation Subscale of Internal State Scale version two) before starting prednisone, after two weeks of prednisone, and at the end of prednisone taper to assess for mood changes. Harvey-Bradshaw Index and Simple Clinical Colitis Activity Index were used to monitor clinical disease activity. RESULTS: Fifty-three subjects were included in the analyses. The rate of mood change after two weeks of prednisone was 49.1%, primarily driven by increase in mood towards (hypo)mania. Younger age was an independent risk factor. Mood state returned to pretreatment level at the end of treatment. There was no correlation between clinical disease activity change and mood change. CONCLUSIONS: Oral prednisone for inflammatory bowel disease flare is associated with high rate of mood change. As prednisone is a critical part of induction therapy, ways to minimize this adverse event must be studied. For now, healthcare providers should inform patients and monitor closely for this adverse event. Oxford University Press 2018-09 2018-06-04 /pmc/articles/PMC6507281/ /pubmed/31294728 http://dx.doi.org/10.1093/jcag/gwy023 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Articles
Ou, George
Bressler, Brian
Galorport, Cherry
Lam, Eric
Ko, Hin Hin
Enns, Robert
Telford, Jennifer
Schaffer, Nathan
Lee, Terry
Rosenfeld, Greg
Rate of Corticosteroid-Induced Mood Changes in Patients with Inflammatory Bowel Disease: A Prospective Study
title Rate of Corticosteroid-Induced Mood Changes in Patients with Inflammatory Bowel Disease: A Prospective Study
title_full Rate of Corticosteroid-Induced Mood Changes in Patients with Inflammatory Bowel Disease: A Prospective Study
title_fullStr Rate of Corticosteroid-Induced Mood Changes in Patients with Inflammatory Bowel Disease: A Prospective Study
title_full_unstemmed Rate of Corticosteroid-Induced Mood Changes in Patients with Inflammatory Bowel Disease: A Prospective Study
title_short Rate of Corticosteroid-Induced Mood Changes in Patients with Inflammatory Bowel Disease: A Prospective Study
title_sort rate of corticosteroid-induced mood changes in patients with inflammatory bowel disease: a prospective study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6507281/
https://www.ncbi.nlm.nih.gov/pubmed/31294728
http://dx.doi.org/10.1093/jcag/gwy023
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