Emotional Functioning of Children with Inflammatory Bowel Disease Under Different Treatment Strategies

Abstract

Aim. To assess emotional functioning in children with Crohn’s disease and ulcerative colitis based on patient and parent reports, to determine differences between the two disease types; and to compare these parameters according to the use of biologic or conventional therapy, disease duration, and the presence of extraintestinal manifestations. Design. Single-center comparative cross-sectional observational study. Materials and methods. The study included 88 children aged 8 to 17 years with inflammatory bowel disease (52 patients with Crohn’s disease and 36 with ulcerative colitis), and one parent for each child. Thirty-seven children received biologic therapy, while 51 received conventional therapy. Emotional functioning was assessed in patients and their parents using the Russian versions of the disease-specific Inflammatory Bowel Disease Quality of Life Questionnaire for Children (IMPACT-III), the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL 4.0), and the Pediatric Quality of Life Inventory Family Impact Module (PedsQL FIM). These parameters were compared according to treatment type, diagnosis, disease duration, and the presence of extraintestinal manifestations. Results. According to the disease-specific IMPACT-III questionnaire, emotional functioning scores were higher in children receiving biologic therapy than in patients receiving conventional therapy: 75.0 [60.7; 85.7] and 64.3 [44.7; 75.0], respectively (p = 0.015). No statistically significant differences were identified in the emotional domains of the PedsQL 4.0 or PedsQL FIM. Emotional functioning parameters did not differ between children with Crohn’s disease and those with ulcerative colitis. Stratified analysis by disease type likewise revealed no statistically significant differences between the treatment groups. Disease duration and the presence of extraintestinal manifestations were not associated with differences in the emotional state of either the children or their parents. A moderate positive correlation was observed between the emotional domains of the IMPACT-III and PedsQL 4.0 (ρ = 0.49; p < 0.001). Conclusion. Biologic therapy was associated with higher emotional functioning scores according to IMPACT-III. No between-group differences were identified using the PedsQL 4.0 or PedsQL FIM. Disease type, disease duration, and the presence of extraintestinal manifestations were not associated with the emotional status of patients or their parents. Keywords: children, quality of life, emotional functioning, inflammatory bowel diseases.