Fatigue Is Strongly Associated with Depressive Symptoms in Patients with Inflammatory Bowel Disease 2025 Hrúz et al

Abstract

Introduction: Fatigue is an extraintestinal manifestation in patients with inflammatory bowel disease (IBD), such as Crohn’s disease (CD) and ulcerative colitis (UC), with limited information on the underlying factors. This study aimed to determine the prevalence of fatigue and associated factors in IBD patients.

Methods: This prospective observational study assessed 216 IBD patients treated with intravenous infliximab or vedolizumab. Clinically meaningful fatigue was defined using a visual analog scale with a score ≥4 (VAS-F, range 0–10). Further assessments included the patient health questionnaire (PHQ-8) for depressive symptoms, the IBD-control-8 questionnaire to evaluate subjective disease control and the fatigue impact scale (FIS) for patients’ quality of life (QoL). Demographic, clinical and laboratory data of the study population were collected and compared to identify fatigue-associated factors.

Results: Overall, 53.2% (n = 115) of the IBD patients reported clinically meaningful fatigue with a higher prevalence in UC (63.0%) versus CD (47.4%). Among patients with CD, disease activity was significantly associated with fatigue symptoms (p < 0.001), whereas no such correlation was observed in UC patients (p = 0.85). Clinically meaningful fatigue symptoms were reported in 90.9% of patients with depressive symptoms (PHQ-8 ≥10). Furthermore, patients with fatigue were younger (40 vs. 42 years, p = 0.04), reported more frequent use of concomitant psychoactive and/or sedative medication (p = 0.03) and had lower IBD-control-8 scores (median 12 vs. 16 points, p < 0.001). Only minor differences were observed when comparing serum and fecal laboratory values of patients with fatigue symptoms to those without.

Conclusion: Fatigue is highly prevalent among IBD patients treated with vedolizumab or infliximab and has a substantial impact on patients’ QoL. Fatigue and depressive symptoms were strongly associated, suggesting closer monitoring for depression and the use of psychoactive medication in patients with IBD.

Open access

 

This is the PHQ-8:

Instructions: Over the last two weeks, how often have you been bothered by the following problems?

0 to 1 day = “not at all,” 2 to 6 days = “several days,” 7 to 11 days = “more than half the days,” and 12 to 14 days = “nearly every day,”

1. Little interest or pleasure in doing things
   
2. Feeling down, depressed, or hopeless
   
3. Trouble falling or staying asleep, or sleeping too much
   
4. Feeling tired or having little energy
   
5. Poor appetite or overeating
   
6. Feeling bad about yourself – or that you are a failure or have let yourself or your family down
   
7. Trouble concentrating on things, such as reading the newspaper or watching television
   
8. Moving or speaking so slowly that other people could not have noticed. Or the opposite – being fidgety or restless that you have been moving around a lot more than usual

According to this I’m very depressed. I think it’s obvious why this questionnaire is worthless for people that are ill.

 

"Lack of frivolous purchases associated with lack disposable income, relationship unclear, expected that a graded frivolous expenses program should raise disposable incomes in motivated individuals"

A child can easily see the gaps in this logic. Hell, most monkeys can if you present it the right way. There is something about medical training that nullifies the basic common sense that is usually thought at elementary school. Even though every one of them can work out the gaps in their reasoning if you simply swap a few terms.