LAS VEGAS (FRONTLINE MEDICAL NEWS) – Among pediatric IBD patients, risk factors for body image dissatisfaction include female gender, older age at diagnosis, active disease, current steroid use, higher body mass index percentile, and comorbid mood disorder.

The findings come from a cross-sectional study of 664 patients enrolled in the Crohn’s & Colitis Foundation’s Partners Kids & Teens cohort, presented by Jennifer Claytor, MS, at the annual congress of the Crohn’s & Colitis Foundation and the American Gastroenterological Association.

Ms. Claytor, a fourth-year medical student at the University of North Carolina at Chapel Hill, and her associates asked study participants aged 5-18 years to complete surveys on demographics, disease characteristics, and the IMPACT-35 questionnaire and Patient-Reported Outcomes Measurement Information System ( PROMIS ) tools for assessment of psychological patient-reported outcomes. The pediatric ulcerative colitis activity index and the short Crohn’s disease activity index were used to measure disease activity.

The researchers classified body image dissatisfaction as being present if the patients selected “I look awful” or “I look bad” from the list of possible responses to the question, “How do you feel about the way you look?” Next, they performed bivariate analyses to assess associations between body image dissatisfaction and demographic, disease-related, and psychosocial factors and created logistic regression models to evaluate independent associations between selected risk factors and body image dissatisfaction. “There has been some literature which suggests that for boys, weight and not body image dissatisfaction predicts worse psychosocial outcomes,” Ms. Claytor said. “But for girls it’s body image dissatisfaction, irrespective of weight.”

Of the 664 patients, 74 (3.3%) met criteria for body image dissatisfaction. Compared with patients who did not meet criteria for body image dissatisfaction, those who did were significantly more likely to be female (69% vs. 44%, respectively; P less than .001), older (mean age of 15 vs. 13 years; P less than .001), and diagnosed with IBD an older age (median of 12 vs. 10 years; P less than .001). Ms. Claytor and her associates also found that individuals with body image dissatisfaction had a higher median BMI percentile (P = .02), higher rates of active disease (57% vs. 26%; P less than .001), higher rates of current steroid use (18% vs. 8%; P = .004), and higher rates of depression and anxiety (P less than .001).

After adjusting for age, body mass index, remission, steroid use, and other factors, the odds for developing body image dissatisfaction was highest among those with anxiety (odd ratio, 5.42), followed by depression (OR 4.73), female gender (OR 2.31), and current steroid use (OR 1.59). “I think this points to the need for enhanced counseling services and being aware of these characteristics,” Ms. Claytor said. She reported having no financial disclosures.

SOURCE: Claytor J et al. Crohn’s & Colitis Congress, Poster 15.


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