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P271. A magic pill? Patients' views on the role of antidepressant therapy in inflammatory bowel disease (IBD)

A. Mikocka-Walus1, A. Gordon1, B. Stewart2, J.M. Andrews3

1University of South Australia, School of Nursing and Midwifery, Adelaide, Australia; 2University of Adelaide, Psychology, Adelaide, Australia; 3Royal Adelaide Hospital, Gastroenterology & Hepatology, Adelaide, Australia

Background: Studies with healthy volunteers have demonstrated that antidepressants can improve immunoregulatory activity and thus they may have a potential to positively impact the disease course in inflammatory bowel disease (IBD). However, patients' views on the role of antidepressants in the management of their IBD are unknown. Thus, this study aimed to explore patients' experiences and opinions regarding the effect of antidepressants on IBD course as well as their attitudes towards future trials with antidepressants.

Methods: Semi-structured in-depth interviews with open-ended questions were conducted with a randomly selected sample of IBD patients recruited at the Australian public hospital IBD clinic and currently receiving antidepressants. A qualitative content analysis was undertaken to summarise patients' responses. A Visual Analogue Scale was used to provide a quantitative assessment of patients' experiences with antidepressants.

Results: Overall, 15 IBD sufferers currently on antidepressants (nine females, six males) were interviewed. All 15 reported a positive response to antidepressants reporting they improved their quality of life, with minimal side-effects. Five patients (33.3%) felt the antidepressant had specifically improved their IBD course. Three patients noted how they believed the reduction in feelings of stress mediated the positive influence of the antidepressant on IBD course. Ten patients (66.7%) felt the antidepressants had not specifically influenced their IBD. Nine patients (60.0%) had a generally positive attitude towards antidepressants, four patients (26.7%) were ambivalent, and two patients (13.3%) held a negative view towards antidepressants. Twelve patients (80.0%) stated that they would be willing to participate in clinical trials.

Conclusions: Antidepressants seem to be well tolerated by IBD patients. One third of patients reported an observable improvement of their IBD under the influence of this treatment. The high acceptance of antidepressants may facilitate the conduct of clinical trials to further assess for any specific role on IBD course.