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P209. Influence of anxiety and depression in the clinical course of inflammatory bowel disease patients

M. Barreiro-de Acosta, M. Iglesias, R. Ferreiro, A. Lorenzo, J.E. Dominguez-Muñoz, University Hospital Santiago de Compostela, Gastroenterology, Santiago, Spain

Background

Anxiety and depression are highly prevalent in IBD patients, but their role in the clinical course of the disease is unknown. We hypothesised that anxiety and depression are predictors of a worse clinical course in IBD. The aim of the study was to evaluate the influence of anxiety and depression symptoms in emergency visits and hospitalisations in IBD patients.

Methods

A prospective observational cohort study was designed. The cohort consisted of consecutive patients with IBD [Crohn's disease (CD) and ulcerative colitis (UC)] who attended our monographic IBD Unit. In order to identify anxiety or depression, a psychological evaluation was performed at baseline in all of them by the Hospital Anxiety and Depression scale (HAD). In order to assess the clinical course of IBD, all emergency visits and hospitalisations related with IBD over a follow-up period of 18 months were recorded. Results are shown as RR and 95% CI and analysed by Poisson Regression.

Results

716 patients were included (343 male, mean age 44.50 years, ages ranging from 18 to 86 years), 297 (41.8%) patients with CD and 413 (58.2%) with UC. At baseline evaluation, anxiety and depression symptoms were present in 75 (10.5%) and 144 (20.1%) patients respectively. The mean of emergency visits was 1.05 (SD: 1.68, range 0–14) and for hospitalizations it was 0.35 (SD: 0.94, range 0–9). After a follow up of 18 months, depression at baseline was a risk factor for more emergency visits (RR: 1.38, 95% CI: 1.14–1.65; p = 0.001) but not anxiety (RR: 1.11, 95% CI: 0.87–1.41; p = 0.395). Regarding hospitalizations in the next 18 months, after controlling by relevant sociodemographic and clinical variables, anxiety and depression (RR: 1.18, 95% CI: 0.75–1.83, p = 0.472; RR: 0.70, 95% CI: 0.75–1.83, p = 0.059) were not risk factors for an increased number of them.

Conclusion

An important number of IBD patients present anxiety or depressive symptoms. Depression seems to be a risk factor for more emergency visits in the following months. Therefore, these patients would probably benefit from psychological support.