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J Pediatr Gastroenterol Nutr. 2014 May;58(5):569-73. doi: 10.1097/MPG.0000000000000277.

Predictors of depression in youth with Crohn disease.

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*Cleveland Clinic, Lerner College of Medicine, Case Western Reserve University, Cleveland, OH †Division of Pediatric Gastroenterology, Children's Hospital of Pittsburgh ‡Graduate School of Public Health §Division of Rheumatology and Clinical Immunology, University of Pittsburgh ||Medical Coping Clinic, Children's Hospital of Pittsburgh, Pittsburgh, PA ¶Department of Gastroenterology #Department of Psychiatry, Boston Children's Hospital, Boston, MA **Department of Psychiatry, Children's Hospital of Pittsburgh, Pittsburgh, PA.



The aim of the study was to determine whether infliximab use and other potential predictors are associated with decreased prevalence and severity of depression in pediatric patients with Crohn disease (CD).


A total of 550 (n = 550) youth ages 9 to 17 years with biopsy-confirmed CD were consecutively recruited as part of a multicenter randomized controlled trial. Out of the 550, 499 patients met study criteria and were included in the analysis. At recruitment, each subject and a parent completed the Children's Depression Inventory (CDI). A child or parent CDI score ≥  12 was used to denote clinically significant depressive symptoms (CSDS). Child and parent CDI scores were summed to form total CDI (CDIT). Infliximab use, demographic information, steroid use, laboratory values, and Pediatric Crohn's Disease Activity Index (PCDAI) were collected as the potential predictors of depression. Univariate regression models were constructed to determine the relations among predictors, CSDS, and CDIT. Stepwise multivariate regression models were constructed to predict the relation between infliximab use and depression while controlling for other predictors of depression.


Infliximab use was not associated with a decreased proportion of CSDS and CDIT after adjusting for multiple comparisons. CSDS and CDIT were positively associated with PCDAI, erythrocyte sedimentation rate, and steroid dose (P < 0.01) and negatively associated with socioeconomic status (SES) (P < 0.001). In multivariate models, PCDAI and SES were the strongest predictors of depression.


Disease activity and SES are significant predictors of depression in youth with Crohn disease.

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