{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T18:27:57Z","timestamp":1774981677716,"version":"3.50.1"},"reference-count":56,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2002Iron deficiency and anemia are common findings in IBD. Treatment of anemia improves quality of life. Neurological symptoms like depression or anxiety are also common in IBD; however, their relationship with ID has not been studied in detail.<\/jats:p><jats:p>\n          Methods\u2002Prospective, single center, non-interventional trial in an IBD cohort (n\u200a=\u200a98), which is generally at risk for ID. Quality of sleep (using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Insomnia Severity Index) and the presence of fatigue (Piper fatigue scale), depression (Self-rating Depression Scale [SDS]) or anxiety (Self-rating Anxiety Scale [SAS]) were related to ID (ferritin, transferrin saturation), anemia (hemoglobin), and inflammatory disease activity (CRP).<\/jats:p><jats:p>\n          Results\u2002ID was present in 35\u200a%, anemia in 16\u200a%, and inflammation in 30\u200a%. The overall quality of sleep in this cohort was similar to that reported for the general population. ID, anemia, or inflammation had no influence on the PSQI (median 4.0 [CI 3.0\u20135.0]), the ESS 5.5 (5.0\u20137.0), and the ISI 4.00 (2.5\u20135.5). Fatigue (PFS; present in 30\u200a%), anxiety (SAS; present in 24\u200a%), and depression (SDS; present in 33\u200a%) were more common than in the general population. Iron deficient and anemic patients were more likely to be depressed (p\u200a=\u200a0.02 and p\u200a&lt;\u200a0.01) and showed a trend towards presence of fatigue (p\u200a=\u200a0.06 and 0.07). Systemic inflammation as measured by CRP had no effect on any of these conditions.<\/jats:p><jats:p>\n          Conclusion\u2002In this IBD cohort, ID and anemia affect depression and possibly fatigue independent of the presence of inflammation.<\/jats:p>","DOI":"10.1055\/a-1283-6832","type":"journal-article","created":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T00:56:24Z","timestamp":1607475384000},"page":"1191-1200","source":"Crossref","is-referenced-by-count":15,"title":["Iron deficiency, depression, and fatigue in inflammatory bowel\u00a0diseases"],"prefix":"10.1055","volume":"58","author":[{"given":"Peter","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Div. of Gastroenterology and Hepatology, Dept Medicine 3"},{"name":"Dept. of Psychiatry"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristine","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Div. of Gastroenterology and Hepatology, Dept Medicine 3"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerda","family":"Saletu-Zyhlarz","sequence":"additional","affiliation":[{"name":"Dept. of Psychiatry"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Mittlb\u00f6ck","sequence":"additional","affiliation":[{"name":"Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Gasche","sequence":"additional","affiliation":[{"name":"Div. of Gastroenterology and Hepatology, Dept Medicine 3"},{"name":"Loha for Life, Centre of Excellence for Iron Deficiency, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1111\/j.1365-2036.2006.03146.x","article-title":"Systematic review: managing anaemia in Crohn\u2019s disease","volume":"24","author":"S Kulnigg","year":"2006","journal-title":"Aliment Pharmacol Ther"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1136\/gut.2010.214312","article-title":"Iron sensing and signalling","volume":"61","author":"R Evstatiev","year":"2012","journal-title":"Gut"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1097\/MEG.0b013e328343b885","article-title":"Serum hepcidin and prohepcidin concentrations in inflammatory bowel disease","volume":"23","author":"P Oustamanolakis","year":"2011","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1002\/ibd.20285","article-title":"Guidelines on the diagnosis and management of iron deficiency and anemia in inflammatory bowel diseases","volume":"13","author":"C Gasche","year":"2007","journal-title":"Inflamm Bowel Dis"},{"key":"ref5","first-page":"447","article-title":"[Iron deficiency, fatigue and restless-legs-syndrome]","volume":"166","author":"B Wurzinger","year":"2016","journal-title":"Wiesner medizinische Wochenschrift"},{"key":"ref6","first-page":"22","article-title":"Prevalence of iron deficiency without anaemia in inflammatory bowel disease and impact on health-related quality of life","volume":"41","author":"C Gonzalez Alayon","year":"2018","journal-title":"Gastroenterologia y hepatologia"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1097\/01.MIB.0000196646.64615.db","article-title":"Effects of changes in hemoglobin level on quality of life and cognitive function in inflammatory bowel disease patients","volume":"12","author":"C W Wells","year":"2006","journal-title":"Inflamm Bowel Dis"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/j.1365-2036.2010.04347.x","article-title":"Systematic review: fatigue in inflammatory bowel disease","volume":"32","author":"D R van Langenberg","year":"2010","journal-title":"Aliment Pharmacol Ther"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1053\/j.gastro.2011.06.005","article-title":"FERGIcor, a randomized controlled trial on ferric carboxymaltose for iron deficiency anemia in inflammatory bowel disease","volume":"141","author":"R Evstatiev","year":"2011","journal-title":"Gastroenterology"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"782","DOI":"10.7326\/0003-4819-126-10-199705150-00006","article-title":"Intravenous iron and erythropoietin for anemia associated with Crohn disease. A randomized, controlled trial","volume":"126","author":"C Gasch\u00e9","year":"1997","journal-title":"Ann Intern Med"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"e94217","DOI":"10.1371\/journal.pone.0094217","article-title":"Evaluation of a single dose of ferric carboxymaltose in fatigued, iron-deficient women\u2013PREFER a randomized, placebo-controlled study","volume":"9","author":"B Favrat","year":"2014","journal-title":"PloS One"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"3222","DOI":"10.1182\/blood-2011-04-346304","article-title":"Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration","volume":"118","author":"P A Krayenbuehl","year":"2011","journal-title":"Blood"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/S0140-6736(96)02341-0","article-title":"Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls","volume":"348","author":"A B Bruner","year":"1996","journal-title":"Lancet"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1136\/bmj.326.7399.1124","article-title":"Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial","volume":"326","author":"F Verdon","year":"2003","journal-title":"BMJ (Clinical research ed)"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"6496727","DOI":"10.1155\/2017\/6496727","article-title":"Prevalence of anxiety and depression in patients with inflammatory bowel disease","volume":"2017","author":"G Byrne","year":"2017","journal-title":"Can J Gastroenterol Hepatol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jpsychores.2016.06.001","article-title":"Depression and anxiety in patients with inflammatory bowel disease: a systematic review","volume":"87","author":"R Neuendorf","year":"2016","journal-title":"J Psychosom Res"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8050654","article-title":"Risk of anxiety and depression in patients with inflammatory bowel disease: a nationwide, population-based study","volume":"8","author":"K Choi","year":"2019","journal-title":"J Clin Med"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1159\/000442929","article-title":"Psychological stress and depression: risk factors for IBD?","volume":"34","author":"C N Bernstein","year":"2016","journal-title":"Dig Dis"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00054725-200002000-00002","article-title":"A simple classification of Crohn\u2019s disease: report of the Working Party for the World Congresses of Gastroenterology, Vienna 1998","volume":"6","author":"C Gasche","year":"2000","journal-title":"Inflamm Bowel Dis"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"5A","DOI":"10.1155\/2005\/269076","article-title":"Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology","volume":"19","author":"M S Silverberg","year":"2005","journal-title":"Can J Gastroenterol"},{"key":"ref21","first-page":"5","article-title":"Nutritional anaemias. Report of a WHO scientific group","volume":"405","author":"WHO","year":"1968","journal-title":"World Health Organization Technical Report Series"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research","volume":"28","author":"D J Buysse","year":"1989","journal-title":"Psychiatry Res"},{"key":"ref23","first-page":"529","article-title":"[Group therapy approaches in primary\/psychophysiologic insomnias]","volume":"145","author":"D Riemann","year":"1995","journal-title":"Wiener medizinische Wochenschrift"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1093\/sleep\/14.6.540","article-title":"A new method for measuring daytime sleepiness: the Epworth sleepiness scale","volume":"14","author":"M W Johns","year":"1991","journal-title":"Sleep"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1159\/000029408","article-title":"German version of the Epworth Sleepiness Scale","volume":"66","author":"K E Bloch","year":"1999","journal-title":"Respiration"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S1389-9457(00)00065-4","article-title":"Validation of the Insomnia Severity Index as an outcome measure for insomnia research","volume":"2","author":"C H Bastien","year":"2001","journal-title":"Sleep Med"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s12888-016-0876-8","article-title":"Validation of the German version of the insomnia severity index in adolescents, young adults and adult workers: results from three cross-sectional studies","volume":"16","author":"M Gerber","year":"2016","journal-title":"BMC Psychiatry"},{"key":"ref28","first-page":"661","article-title":"Piper fatigue scale available for clinical testing","volume":"17","author":"B F Piper","year":"1990","journal-title":"Oncol Nurs Forum"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/S0885-3924(03)00073-3","article-title":"Validation of the German version of the brief fatigue inventory","volume":"25","author":"L Radbruch","year":"2003","journal-title":"J Pain Symptom Manage"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/S0033-3182(71)71479-0","article-title":"A rating instrument for anxiety disorders","volume":"12","author":"W W Zung","year":"1971","journal-title":"Psychosomatics"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.sleep.2016.03.008","article-title":"Sleep quality in the general population: psychometric properties of the Pittsburgh Sleep Quality Index, derived from a German community sample of 9284 people","volume":"30","author":"A Hinz","year":"2017","journal-title":"Sleep Med"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1034\/j.1600-0404.2000.102004249.x","article-title":"Sleep and quality of life in the Austrian population","volume":"102","author":"J Zeitlhofer","year":"2000","journal-title":"Acta Neurol Scand"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1007\/s11325-016-1363-7","article-title":"Normative values of the Epworth Sleepiness Scale (ESS), derived from a large German sample","volume":"20","author":"C Sander","year":"2016","journal-title":"Sleep Breath"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1001\/jama.1988.03410070057028","article-title":"Chronic fatigue in primary care. Prevalence, patient characteristics, and outcome","volume":"260","author":"K Kroenke","year":"1988","journal-title":"J Am Med Assoc"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/1741-7015-9-90","article-title":"Cross-national epidemiology of DSM-IV major depressive episode","volume":"9","author":"E Bromet","year":"2011","journal-title":"BMC Med"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1002\/ibd.21346","article-title":"Anxiety and depression in patients with inflammatory bowel disease: comparisons with chronic liver disease patients and the general population","volume":"17","author":"W H\u00e4user","year":"2011","journal-title":"Inflamm Bowel Dis"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1186\/s12888-020-02621-0","article-title":"Psychiatric disorders risk in patients with iron deficiency anemia and association with iron supplementation medications: a nationwide database analysis","volume":"20","author":"H S Lee","year":"2020","journal-title":"BMC Psychiatry"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.psychres.2011.03.009","article-title":"Association between serum ferritin concentrations and depressive symptoms in Japanese municipal employees","volume":"189","author":"S Yi","year":"2011","journal-title":"Psychiatry Research"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1038\/sj.ejcn.1602542","article-title":"The relationship between depression and serum ferritin level","volume":"61","author":"M Vahdat Shariatpanaahi","year":"2007","journal-title":"Eur J Clin Nutr"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"456","DOI":"10.29271\/jcpsp.2018.06.456","article-title":"Relation between depressive disorder and iron deficiency anemia among adults reporting to a secondary healthcare facility: a hospital-based case control study","volume":"28","author":"M Shafi","year":"2018","journal-title":"J Coll Physicians Surg Pak"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/PSY.0b013e3182414f7d","article-title":"Relationship between depressive symptoms, anemia, and iron status in older residents from a national survey population","volume":"74","author":"R Stewart","year":"2012","journal-title":"Psychosom Med"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/j.jogc.2017.09.027","article-title":"Iron deficiency and risk of maternal depression in pregnancy: an observational study","volume":"40","author":"M Dama","year":"2018","journal-title":"J Obstet Gynaecol Can"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1007\/s00394-015-1140-6","article-title":"The efficacy of early iron supplementation on postpartum depression, a randomized double-blind placebo-controlled trial","volume":"56","author":"M Sheikh","year":"2017","journal-title":"Eur J Nutr"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S0016-5085(76)80163-1","article-title":"Development of a Crohn\u2019s disease activity index. National cooperative Crohn\u2019s disease study","volume":"70","author":"W R Best","year":"1976","journal-title":"Gastroenterology"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1136\/bmj.298.6666.82","article-title":"Coated mesalazine (5-aminosalicylic acid) versus sulphasalazine in the treatment of active ulcerative colitis: a randomised trial","volume":"298","author":"D Rachmilewitz","year":"1989","journal-title":"BMJ (Clinical research ed)"},{"issue":"S 02","key":"ref46","first-page":"203","article-title":"Gender related differences in quality of life and affective status in patients with inflammatory bowel disease","volume":"35","author":"G Hauser","year":"2011","journal-title":"Coll Antropol"},{"key":"ref47","doi-asserted-by":"crossref","first-page":"e00497","DOI":"10.1002\/brb3.497","article-title":"A systematic review of reviews on the prevalence of anxiety disorders in adult populations","volume":"6","author":"O Remes","year":"2016","journal-title":"Brain and Behavior"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1177\/2050640617703868","article-title":"Psychological distress, iron deficiency, active disease and female gender are independent risk factors for fatigue in patients with ulcerative colitis","volume":"6","author":"B Jonefjall","year":"2018","journal-title":"United European Gastroenterol J"},{"key":"ref49","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1038\/ajg.2013.14","article-title":"Is iron deficiency in the absence of anemia associated with fatigue in inflammatory bowel disease?","volume":"108","author":"B A Goldenberg","year":"2013","journal-title":"Am J Gastroenterol"},{"key":"ref50","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1097\/MIB.0000000000000768","article-title":"Iron deficiency in the absence of anemia impairs the perception of health-related quality of life of patients with inflammatory bowel disease","volume":"22","author":"C Herrera-deGuise","year":"2016","journal-title":"Inflamm Bowel Dis"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1111\/j.1432-1033.1996.00432.x","article-title":"M\u00f6ssbauer, electron-paramagnetic-resonance and X-ray-absorption fine-structure studies of the iron environment in recombinant human tyrosine hydroxylase","volume":"241","author":"W Meyer-Klaucke","year":"1996","journal-title":"Eur J Biochem"},{"key":"ref52","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1111\/j.1572-0241.2007.01744.x","article-title":"A novel intravenous iron formulation for treatment of anemia in inflammatory bowel disease: the\u00a0ferric carboxymaltose (FERINJECT) randomized controlled trial","volume":"103","author":"S Kulnigg","year":"2008","journal-title":"Am J Gastroenterol"},{"key":"ref53","first-page":"1431","article-title":"[Updated German clinical practice guideline on \u201cDiagnosis and treatment of Crohn\u2019s disease\u201d 2014]","volume":"52","author":"J C Preiss","year":"2014","journal-title":"Z\u00a0Gastroenterol"},{"key":"ref54","doi-asserted-by":"crossref","first-page":"e397","DOI":"10.1055\/a-1015-7324","volume":"57","author":"P van Leeuwen","year":"2019","journal-title":"Z Gastroenterol"},{"key":"ref55","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/MIB.0000000000000953","article-title":"Assessment of gaps in care and the development of a care pathway for anemia in patients with inflammatory bowel diseases","volume":"23","author":"J K Hou","year":"2017","journal-title":"Inflamm Bowel Dis"},{"key":"ref56","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1093\/ibd\/izz045","article-title":"The prevalence and risk factors of undiagnosed depression and anxiety disorders among patients with inflammatory bowel disease","volume":"25","author":"K Lewis","year":"2019","journal-title":"Inflamm Bowel Dis"}],"container-title":["Zeitschrift f\u00fcr Gastroenterologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1283-6832.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T00:59:38Z","timestamp":1607475578000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1283-6832"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":56,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,8]]},"published-print":{"date-parts":[[2020,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1283-6832","relation":{},"ISSN":["0044-2771","1439-7803"],"issn-type":[{"value":"0044-2771","type":"print"},{"value":"1439-7803","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]}}}