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P306. Analysis of psychological and psychosocial impairment factors in patients with inflammatory bowel disease

E. Krauss1, K. Hake2, A. Kleist3, J. Peirano4, T. Krause5, R. Ehehalt6, P. von Arnauld de la Perriere7, J. Buening8, O. Treml9, B. Siegmund10, C. Maaser11, B. Bokemeyer12, D.C. Baumgart10, M. Neurath1, J. Mudter1, 1University of Erlangen-Nuremberg, Department of Medicine 1, Erlangen, Germany, 2Medical Faculty of the University of Rostock, Clinic for Psychosomatic and Psychotherapeutic Medicine, Rostock, Germany, 3University of Erlangen-Nuremberg, Department of Medicine 1, D-91054 Erlangen, Germany, 4Psychotherapeutic clinic with a focus on IBD, Hamburg, Germany, 5Gastroenterological clinic, Kassel, Germany, 6University Hospital Heidelberg, Department of Medicine IV, Heidelberg, Germany, 7Gastroenterological clinic, Hamburg, Germany, 8University Clinic Schleswig-Holstein, Luebeck, Germany, 9FC Hagen-Gastroenterology, Hagen, Germany, 10Charité – University Berlin, Berlin, Germany, 11Municipal Hospital of Lueneburg, Lueneburg, Germany, 12Gastroenterological Clinic, Minden, Germany

Background

Patients with IBD show complex emotional and psychological impairments, which have a great impact on their social life. Along with physical and social ailments, the IBD consequently lead to a constant psychological distress. We report current data from a nationwide questionnaire survey of German IBD Study Group (GISG) study centers.

Methods

The patients' recruitment was conducted nationwide by 30 GISG study centers from 09/2011 to 03/2012. We interviewed Crohn's disease and ulcerative colitis patients (CD, UC) from university outpatient clinics and gastroenterological practices. The exclusion criteria for all participants were chronic diseases in advanced stages, oncological and psychiatric disorders, as well as an existing pregnancy. The control group consisted of “average people” age-matched to IBD patients. The response rate of 1085 questionnaires was 35%. The survey consisted of a clinical and psychological part; over 100 parameters were analyzed. The general characteristic (age, education, family history of the disease, therapy, presence of other medical conditions, restriction of social participation, etc.) of each group was generated. The following validated scores were used additionaly: GIBDI CD / UC, Mayo UC, SCL 90, SVF, HPI. The statistical analysis was carried out by MediStat, Kiel, Germany.

Results

The psychological impairments with statistical significance were found only in the CD group; the UC group showed mild ailments which did not differ significantly from the controls. CD patients showed insecurity in social contact, padj < 0.001; depression padj = 0.024. Also a significant difference could be detected in nervousness, sensitivity and emotional instability (padj = 0.036), altogether with an increased need for social support (padj = 0.004). The changes were statistically significantly detectable also in remission of the disease; the expression depended on the severity of CD.

Conclusion

In summary, our results demonstrate an increased need for multimodal therapy of IBD patients, especially CD and thus contribute to the development of a psychosomatic care.