Risk factors associated with anxiety and depression in patients with inflammatory bowel disease identified using structural equation modeling

Abstract

BACKGROUND

Anxiety and depression are common among patients with inflammatory bowel disease (IBD), negatively affecting their quality of life and disease prognosis. Previous studies have mainly focused on univariate analyses, with limited exploration of complex factor interactions. This study hypothesizes that sleep quality and coping styles directly and indirectly influence IBD-related anxiety and depression through structural equation modeling (SEM).

AIM

To construct a structural equation model to examine how various factors influence anxiety and depression in patients with IBD.

METHODS

An observational study involving 247 patients with IBD was conducted at Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City) from March 2023 to December 2024. Data were collected using a general information questionnaire, the Hospital Anxiety and Depression Scale, the Medical Coping Modes Questionnaire (MCMQ), and the Pittsburgh Sleep Quality Index (PSQI). Spearman correlation was used to assess variable relationships, and SEM was applied to analyze factors influencing anxiety and depression.

RESULTS

PSQI score [11 (10-13)] and MCMQ score [44 (43-45)] were significantly correlated with Hospital Anxiety and Depression Scale score [15 (13-20), P < 0.001]. The SEM demonstrated a good model fit (χ²/df = 1.039, root mean square error of approximation = 0.013, comparative fit index = 0.999). PSQI had a direct positive effect on anxiety and depression (β = 3.223, P < 0.01) and an indirect effect mediated through MCMQ (β = 2.335, P < 0.01). MCMQ also had a direct positive effect (β = 1.859, P < 0.01).

CONCLUSION

Poor sleep and maladaptive coping contribute to anxiety and depression in patients with IBD. Targeted psychosocial interventions may improve mental health outcomes in this patient population.

Keywords: Inflammatory bowel disease; Anxiety; Depression; Structural equation modeling; Influencing factors; Medical coping modes

Core Tip: This study applies structural equation modeling to explore factors influencing anxiety and depression in patients with inflammatory bowel disease. It identifies sleep quality and coping modes as key factors influencing anxiety and depression in patients with inflammatory bowel disease. These findings highlight the need for tailored interventions like sleep hygiene education and cognitive-behavioral strategies, could significantly alleviate anxiety and depression, thereby improving overall mental health outcomes and quality of life in this patient population.