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P335. How is the coping in patients with inflammatory bowel disease?

M. Iglesias1, M. Barreiro-de Acosta1, I. Vázquez2, M. Piñeiro1, A. Figueiras1, A. Lorenzo1, J. Dominguez-Muñoz1

1University Hospital, Santiago de Compostela, Spain; 2Psychology University, Santiago de Compostela, Spain

Aim: Coping strategies are used to manage conflict and illness and can have adaptative or maladaptative effects on health status. Coping strategies have not been well studied in Inflammatory Bowel Disease (IBD). Investigating psychological adjustment to IBD is important because it may help to further explain patient reported outcomes in IBD. Aim of present study was to assess the coping strategies in patients with IBD and to determine differences between gender, clinical activity and different IBD diseases (Crohn's disease (CD) or ulcerative colitis (UC)).

Methods: A prospective study with consecutive inclusion of patients was designed. CD and UC patients older than 18 years were included. Patients were stratified according to demographic parameters and clinical activity (Harvey-Bradshaw for CD or Mayo for UC). Remission was defined in CD as a Harvey-Bradshaw score ≤4 or and in UC as a Mayo score ≤2. Coping strategies were assessed with the COPE scale Spanish version. It has 60 items and participants rated themselves using the dispositional response format, and indicated how frequently they engaged in each coping behavior on a 4-point scale. The scale had 6 different global strategies: Behavioral Coping Problem, Cognitive Coping Problem, Cognitive Escape, Emotion-focused Coping, Escape Behavior and Consumption of Alcohol or drugs. Differences in coping between CD patients and UC, sex and clinical activity were analyzed with ANOVA test or Kruskal-Wallis where was appropriate.

Results: 660 consecutive patients were included; (317 (48%) male, mean age 44.19 years, range 18–86 years), 261 (40%) patients with CD and 399 (60%) with UC. The most frequently Coping strategies used by IBD patients were Behavioral Coping Problem (mean: 2.73 standard deviation (SD): 0.44) and Escape Behavior (mean: 2.39 SD: 0.32), and the less frequently used were Cognitive Escape (mean: 1.67, SD: 0.44) and Consumption of Alcohol or drugs (mean: 1.04, SD: 0.19). We have not found differences between CD strategies and UC strategies (p = ns). Strategies were also similar between patients with and without remission (p = ns). Women used more frequently than men Cognitive Escape (p = 0.003) and Emotion-focused Coping (p < 0.005).

Conclusions: The coping strategies most used in IBD patients were Behavioral Coping Problem and Escape Behavior. Consumption of Alcohol or drugs was uncommon in IBD patients. The coping strategies do not seem to depend on the level of disease activity or type of disease.