Aug 2026· Nursing Reports· Vol 16, pp. 301· 0 citations· 61 references
TL;DR
Results highlight the importance of systematic psychological assessment, early identification of emotional distress, and integrated multidisciplinary care, including nursing-led screening and supportive interventions, for individuals newly diagnosed with IBD.
Abstract
Background/Objectives: Psychological distress, including symptoms of anxiety and depression, is common among individuals with inflammatory bowel disease (IBD) and may adversely affect well-being and disease management. However, routine assessment of mental health is not consistently integrated into clinical care. This study assessed the prevalence of anxiety and depression among patients newly diagnosed with IBD at diagnosis and after three months of treatment and explored associations between psychological symptoms, disease activity, and clinical characteristics. Methods: This prospective cohort study included 304 adults newly diagnosed with IBD and treated at Stavanger University Hospital between 2012 and 2019. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale at baseline and after three months. Disease activity was evaluated using the Harvey–Bradshaw Index and Partial Mayo Score. Clinical variables included C-reactive protein, faecal calprotectin, folate, cobalamin, and body mass index. Multivariable regression analyses were conducted to identify factors associated with psychological symptoms. Results: The prevalence of anxiety decreased from 29.8% at diagnosis to 21.6% after three months, while the prevalence of combined anxiety and depression declined from 22.2% to 16.3%. The prevalence of depression alone remained stable over time. Higher disease activity, particularly as measured by the Harvey–Bradshaw Index, showed the strongest association with anxiety and depressive symptoms. However, after adjustment for potential confounders, no significant improvement in psychological symptoms was observed, suggesting that the association between time and HADS scores may be explained by changes in one or more measured covariates. Conclusions: Psychological symptoms remained common during the first months following an IBD diagnosis and were closely associated with disease activity. Medical treatment alone was insufficient to achieve meaningful improvements in mental health outcomes. These findings highlight the importance of systematic psychological assessment, early identification of emotional distress, and integrated multidisciplinary care, including nursing-led screening and supportive interventions, for individuals newly diagnosed with IBD.
Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease with substantial physical and psychological impact. Anxiety and depression are common comorbidities that may affect disease outcomes, but their association with disease activity remains inconsistent, particularly in Indonesia. Objective: This study aimed to analyze clinical and demographic predictors of anxiety and depression in RA patients, with emphasis on their association with disease activity measured by DAS28-CRP. Methods: A cross-sectional study was conducted on 58 RA patients at Royal Prima Hospital, Medan. Demographic and clinical variables were recorded. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), and disease activity was measured with DAS28-CRP. Associations were tested using logistic regression, and correlations were analyzed with Spearman’s rank test. Results: The mean age was 47.9 years, and 91.4% were female. Anxiety was identified in 19.0% and depression in 17.2% of participants. High DAS28-CRP was significantly associated with anxiety (OR 5.07; 95% CI 1.26–20.37; p=0.016). In multivariate analysis, DAS28-CRP remained the strongest predictor of anxiety (AOR 3.89; p=0.073), although not statistically significant. Depression was not associated with demographic or clinical characteristics. Spearman correlation showed a positive association between DAS28-CRP and anxiety scores (r=0.304; p=0.020), while the correlation with depression was weaker and not significant. Conclusion: Anxiety, but not depression, was associated with higher disease activity in RA patients. Routine psychological screening, particularly for anxiety, should be incorporated into RA management
Herlina Yani· Indonesian Journal of Rheuma...· 0 citations
Background: Psychological morbidity is increasingly recognized as an important component of rheumatoid arthritis (RA), but its relationship with clinical disease activity remains incompletely understood.
Objective: To assess depression, anxiety, and stress among patients with RA using the Depression Anxiety Stress Scale-21 (DASS-21) and examine their relationship with disease activity assessed using the Clinical Disease Activity Index (CDAI).
Methods: This cross-sectional analysis included 93 patients with RA. Participants were categorized into low, moderate, and high disease activity according to CDAI. Depression, anxiety, and stress were assessed using DASS-21. Domain scores were compared across disease-activity groups using the Kruskal-Wallis test.
Results: Of the 93 participants, 15 (16.1%) had low, 52 (55.9%) moderate, and 26 (28.0%) high disease activity. Depressive symptoms were present in 33 (35.5%), anxiety symptoms in 37 (39.8%), and stress symptoms in 10 (10.8%) patients. Median depression scores were 4 (0-9), 6 (2-12), and 6 (2-11.5) in the low-, moderate-, and high-disease-activity groups, respectively (P=0.493). Corresponding anxiety scores were 6 (3-8), 6 (2-8.5), and 6 (2-10) (P=0.897), while stress scores were 8 (4-10), 8 (4-12), and 9 (4-12) (P=0.725).
Conclusion: Depression and anxiety symptoms were relatively common among patients with RA but did not differ significantly according to CDAI disease activity. Psychological morbidity may therefore represent an important dimension of RA that is not adequately reflected by conventional measures of clinical disease activity.
Keywords: Rheumatoid arthritis; Anxiety
S. Isac, A. Ganguly, Loveleen Kaur et al.· International Journal of Med...· 0 citations
Introduction: Mental health disorders, including depression, anxiety, and stress, are common among patients with Systemic Lupus Erythematosus (SLE) and may adversely affect disease outcomes. Disease activity and corticosteroid exposure have been proposed as important contributors to psychological disturbances. This study aimed to investigate the association between disease activity, cumulative corticosteroid dose, and mental health outcomes among female patients with SLE. Methods: A cross-sectional observational study was conducted among female SLE patients admitted to Haji Adam Malik General Hospital, Medan, Indonesia, between May and November 2024. Mental health outcomes were assessed using the Depression Anxiety Stress Scale-42 (DASS-42). Disease activity was evaluated using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). Univariable, bivariate, and multivariable analyses were performed using SPSS version 27 with a 95% confidence interval. Results: A total of 87 female patients with systemic lupus erythematosus (SLE) were included in this study, with a mean age of 31.8 ± 1.09 years. The mean cumulative corticosteroid dose was 4290.2 ± 459.1 mg, while the mean treatment duration was 24.8 ± 2.62 months. Based on SLEDAI-2K assessment, most participants exhibited mild-to-moderate disease activity (64.4%), whereas 12.6% and 16.1% had high and very high disease activity, respectively. Depression was identified in 54 participants (62.0%), anxiety in 64 participants (73.5%), and stress in 49 participants (56.3%). Bivariate analysis demonstrated significant correlations between cumulative corticosteroid dose, treatment duration, and SLEDAI-2K score with depression, anxiety, and stress levels (all p < 0.05). After adjustment for potential confounders, cumulative corticosteroid dose (p = 0.03) and disease activity measured by SLEDAI-2K (p = 0.001) remained independently associated with adverse mental health outcomes. Conclusion: Disease activity and cumulative corticosteroid exposure were significantly associated with mental health outcomes in patients with systemic lupus erythematosus. Further studies are needed to clarify the causal relationships underlying these associations.
Rizka Arief Puteri Madina Nasution, A. R. Ginting· Indonesian Journal of Rheuma...· 0 citations
Background: Ulcerative colitis is a chronic inflammatory bowel disease that profoundly affects patients’ physical, psychological, and social well-being. Understanding the psychological and behavioral mechanisms that bridge the relationship between biological disease activity and quality of life is essential for developing effective nursing interventions. Objective: This cross-sectional study aimed to examine the relationship between clinical disease activity and quality of life in patients with ulcerative colitis, specifically investigating the mediating roles of comfort and patient activation within a biopsychosocial framework. Methods: Data were collected from 223 adult patients diagnosed with ulcerative colitis attending an outpatient gastroenterology clinic in Western Türkiye between May and August 2025. Clinical disease activity, comfort, patient activation, and quality of life were measured using standardized, validated scales. Data were analyzed using hierarchical multiple regression and serial mediation analysis. Results: Disease activity was strongly and negatively correlated with both quality of life (r = 0.69) and comfort (r = −0.47). Comfort, in turn, showed a strong positive correlation with quality of life (r = 0.66). Mediation analysis confirmed that comfort partially mediated the negative relationship between clinical disease activity and quality of life. However, patient activation did not demonstrate a significant mediating effect in the proposed serial model. Conclusion: Comfort acts as a critical psychological and experiential mechanism that helps mitigate the adverse effects of disease activity on the quality of life of patients with ulcerative colitis. Nursing care should prioritize strategies focusing on enhancing patients’ physical, psychological, and emotional comfort to achieve better health outcomes.
Y. Artan, Amine Terzi, Derin Kahiloğullari et al.· Western Journal of Nursing R...· 0 citations
Background and Objectives: Anxiety and depression are among the most common psychological symptoms in patients with cancer and are associated with morbidity and impaired health-related quality of life (HRQoL), independent of the cancer stage. This study aimed to determine the prevalence of clinically significant anxiety and depression among adult oncology patients in Iraq and quantify the independent contribution of these symptoms to HRQoL. Materials and Methods: A cross-sectional study was conducted between 1 November and 15 December 2024, at the National Oncology Hospital in Najaf, Iraq. A total of 200 adult oncology patients were enrolled using consecutive sampling. Symptoms were measured using the Hospital Anxiety and Depression Scale (HADS), and HRQoL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G). Descriptive statistics were used to summarize sample characteristics. Group comparisons were performed using Pearson’s chi-square test, the Fisher–Freeman–Halton exact test with Monte Carlo estimation, and one-way ANOVA, as appropriate. Associations among continuous variables were assessed using Pearson’s correlation and multiple linear regression. Statistical significance was set at p < 0.05. Results: The mean age (SD) was 52.2 (12.0) years, and 64.0% of the participants were male. Severe anxiety and severe depression were observed in 41.0% and 34.0% of the participants, respectively. Anxiety severity was significantly associated with age, sex, marital status, and treatment modality (all p < 0.01) and was significantly higher in females (58.3% vs. 31.2%) and unmarried patients. Depression severity was significantly associated with age (p = 0.005), sex (p < 0.001), and marital status (p < 0.001) but not with cancer stage (p = 0.223) or treatment modality (p = 0.530). The mean total FACT-G score was 58.2 (14.6), indicating low-to-moderate HRQoL. HADS-A and HADS-D were strongly intercorrelated (r = 0.741) and inversely correlated with FACT-G (r = −0.750 and r = −0.780, respectively; all p < 0.001). Multiple linear regression showed that higher HADS-A and HADS-D scores were independently associated with lower HRQoL, and the full seven-predictor model explained approximately 62% of the variance in FACT-G total scores (R2 = 0.62). Conclusions: Severe anxiety and severe depression were observed in 41.0% and 34.0% of participants, respectively. Higher anxiety and depression scores were independently associated with lower HRQoL.
A. Alkhaqani, Miklós Sugár, A. Jaber et al.· Medicina· 0 citations
Objective: This study assessed the prevalence of fear of cancer recurrence (FCR) and its clinical, treatment-related, and psychological correlates in breast cancer survivors without active disease. Materials and Methods: This cross-sectional study included 200 breast cancer survivors after curative treatment. FCR was assessed using the Fear of Cancer Recurrence Inventory–Short Form (FCRI-SF), with scores ≥ 13 indicating clinically significant FCR. Hospital Anxiety and Depression Scale-Anxiety (HADS-A) and Depression (HADS-D) scores ≥ 8 indicated clinically significant symptoms. Associations with FCR were analyzed using logistic regression, with HADS-A and HADS-D evaluated in separate multivariable models because of their potential overlap. Results: The mean age was 55.6 ± 9.5 years; clinically significant FCR, anxiety, and depression occurred in 38.0%, 32.5%, and 38.0%, respectively. In univariable analysis, younger age, stage III disease, mastectomy, chemotherapy history, and high HADS-A and HADS-D were associated with FCR. In the HADS-A model, chemotherapy history (adjusted OR: 5.841; p = 0.006) and high HADS-A (adjusted OR: 7.828; p < 0.001) were independently associated with FCR, whereas increasing age was protective (adjusted OR: 0.855; p < 0.001). In the HADS-D model, mastectomy (adjusted OR: 6.265; p = 0.002), chemotherapy history (adjusted OR: 6.941; p = 0.001), and high HADS-D (adjusted OR: 14.343; p < 0.001) were independently associated with FCR, whereas increasing age was protective (adjusted OR: 0.836; p < 0.001). Conclusions: FCR is a major psychosocial concern among breast cancer survivors, particularly in younger patients, those with chemotherapy history, and those with greater psychological symptom burden. The association with mastectomy should also be considered, particularly in patients with depressive symptoms.
