Hypothalamic-pituitary-adrenal dysregulation and psychological distress in Crohn’s disease: Insights from acute and chronic stress responses

Table 1 Demographics and disease characteristics of 101 outpatients with Crohn’s disease, mean ± SD/median (interquartile ranges)

Characteristic	Value
Age in years	38.2 (13.2)
Male, %	57.9
Educational status, %
Illiterate	1.5
Basic	46.2
Secondary	20
Technical/university degree	32.3
HBI	1 (1–3)
Smoker, %	40.8
Montreal classification, %
A1/A2/A31	8.5/70.7/20.7
B1/B2/B32	51.3/38.5/10.3
L1/L2/L3/L43	43.6/10.3/46.2
P value	28.4
Under biologic treatment, %	72
Hemoglobin in g/dL	13.4 (1.8)
Anemia, %	10.3
CRP in mg/L	0.8 (0.3–2.7)
History of Crohn’s-related surgery, %	34.7
Extra-intestinal manifestations, %	39.4

¹Age at diagnosis: A1: ≤ 16 years old; A2: 17-40 years old; A3: > 40 years old.

²Behavior: B1: Non-structuring, non-penetrating; B2: Structuring; B3: Penetrating.

³Location: L1: Ileal; L2: Colonic; L3: Ileocolonic; L4: Upper gastrointestinal.

HBI: Harvey-Bradshaw Index; CRP: C-reactive protein.

Table 2 Linear regression analysis of factors associated with higher Depression Anxiety Stress Scale 21 stress scores in patients with Crohn’s disease

Stress	Univariate		Multivariate
	β (95%CI)	P value	β (95%CI)	P value
Female	4.5 (1.5 to 7.5)	0.003	-8.7 (-20.5 to 3.2)	0.145
HBI	1.2 (0.1 to 2.2)	0.03	1.7 (-1.5 to 4.9)	0.281
HGB	-1.6 (-3 to -0.2)	0.022	-4.1 (-7.6 to -0.6)	0.023
Smoking	6.9 (2.5 to 11.3)	0.003	9.5 (3.1 to 18.4)	0.008
A Montreal1
A1	Reference
A2	4.0 (-2.0 to 9.9)	0.239	-3.7 (-15.9 to 8.6)	0.541
A3	7.7 (1.2 to 14.2)	0.014	8.5 (-4.2 to 21.3)	0.181

¹Age at diagnosis: A1: ≤ 16 years old; A2: 17-40 years old; A3: > 40 years old.

HBI: Harvey–Bradshaw Index; HGB: Hemoglobin; CI: Confidence interval.

Table 3 Linear regression analysis of factors associated with higher Depression Anxiety Stress Scale 21 anxiety scores in patients with Crohn’s disease

Anxiety	Univariate		Multivariate
	β (95%CI)	P value	β (95%CI)	P value
Female	3.8 (1.5-6.1)	0.001	4.2 (-0.3 to 10.5)	0.065
HBI	1.7 (0.8-2.5)	< 0.001	2.3 (0.9-3.8)	0.002
Smoking	5.0 (1.3-8.7)	0.008	5.9 (1.4-10.5)	0.012
A Montreal1
A1	Reference
A2	2.2 (-2.7 to 7.0)	0.380	-5.6 (-13.7 to 2.4)	0.164
A3	4.6 (-0.8 to 9.9)	0.092	-0.5 (-8.9 to 8.0)	0.913
L Montreal2
L1	Reference
L2	1.5 (-3 to 5.9)	0.515	-0.3 (-6.8 to 7.4)	0.933
L3	3.4 (0.5-6.4)	0.024	4.9 (0.1-9.7)	0.046

¹Age at diagnosis: A1: ≤ 16 years old; A2: 17-40 years old; A3: > 40 years old.

²Location: L1: Ileal; L2: Colonic; L3: Ileocolonic; L4: Upper gastrointestinal.

HBI: Harvey–Bradshaw Index; CI: Confidence interval.

Table 4 Linear regression analysis of factors associated with higher Depression Anxiety Stress Scale 21 depression scores in patients with Crohn’s disease

Depression	Univariate		Multivariate
	β (95%CI)	P value	β (95%CI)	P value
Female	3.7 (0.7-6.7)	0.016	-5.2 (-19.0 to 8.6)	0.447
Age	0.2 (0.0-0.3)	0.011	-0.2 (-0.8 to 0.4)	0.491
HBI	1.1 (0.1-2.2)	0.039	1.8 (-1.8 to 5.4)	0.323
HGB	-1.6 (-3.0 to -0.2)	0.030	-5.1 (-9.6 to -0.6)	0.027
Smoking	6.1 (1.5-10.6)	0.010	7.9 (-1.1 to 16.8)	0.084
A Montreal1
A1	Reference
A2	5 (-1.1 to 11.0)	0.125	6.3 (-11.7 to 24.3)	0.477
A3	10.1 (3.5-16.7)	0.003	21.3 (-6.9 to 49.5)	0.132

¹Age at diagnosis: A1: ≤ 16 years old; A2: 17-40 years old; A3: > 40 years old.

HBI: Harvey–Bradshaw Index; HGB: Hemoglobin; CI: Confidence interval.