The following is a summary of “Predictors of symptom trajectory in newly diagnosed ulcerative colitis: a 3-year follow-up cohort study,” published in the March 2024 issue of Gastroenterology by Houte et al.
Prior studies have found a link between psychological symptoms and worse outcomes in ulcerative colitis (UC), but most of this research was limited to a single point in time.
Researchers conducted a retrospective study identifying patient subgroups based on how their gastrointestinal (GI) symptoms and quality of life changed over time and to untangle whether GI symptoms or psychological distress influenced each other more.
They evaluated 98 patients newly diagnosed with UC at disease onset and annually for 3 consecutive years. Self-reported GI symptom severity, HRQoL, inflammatory biomarkers, and psychological distress were assessed. Latent class growth analysis was employed to determine subgroups based on longitudinal trajectories of symptom severity and HRQoL, and baseline predictors of trajectory group membership were identified. Cross-lagged structural equation models were utilized to disentangle temporal relationships between psychological functioning and symptom severity.
The results showed that patients with elevated initial psychological distress were more likely to sustain elevated levels of diarrhea and abdominal pain. Conversely, patients with lower baseline levels of diarrhea and abdominal pain were more likely to maintain lower levels of psychological distress. Anti-inflammatory treatment and higher C-reactive protein (CRP) levels at the start predicted greater improvement in mental health. Interestingly, reductions in diarrhea and abdominal pain came before improved psychological symptoms.
Investigators concluded earlier mental distress predicted worse gut symptoms and mental well-being, while gut pain predicted future mental anguish, suggesting interventions for both could improve outcomes.
Source: academic.oup.com/ecco-jcc/advance-article-abstract/doi/10.1093/ecco-jcc/jjae046/7637322
