P627. Exaggeration of physical symptoms in inflammatory bowel disease: Relation to depression, anxiety and quality of life
Recent studies suggest that higher levels of anxiety and depressive symptoms in inflammatory bowel disease (IBD) are not only related to disease activity and severity. Individual characteristics also affect patients experienced distress. This study aimed to determine the relation of exaggeration of physical symptoms with depression, anxiety and quality of life (QOL) in IBD.
49 IBD (37 male) outpatients in remission included in the study. Hospital Anxiety and Depression Scale (HADS), General Health Questionnaire (GHQ-12), Somatosensory Amplification Scale (SSAS), Short form-36 (SF-36) were used to measure depression, anxiety, exaggeration of physical symptoms and quality of life, respectively. For HADS, scores of >7 are considered to reflect a clinical level of anxiety and/or depression. For SSAS, scores of >24 describe a physical discomfort which does not indicate a disease. For SF-36, national average scores (86.6±25.2 for physical function; 86.1±20.6 for pain; 73.5±11.6 for mental health; 94.8±14.2 for social function) were used to compare.
The sample consist of 30 ulcerative colitis and 19 Crohn's disease with a mean age 40.14±12.55 years. The mean scores of the tests of all patients were; SSAS= 26.40±6.17, In HADS depression=7.2±5.35 anxiety=5.93±5.06, In SF-36 physical function=80.49±12.77 pain=86.1±20.6 mental health=67.44±9.72 social function=81.93±13.60. HADS depression and SSAS mean scores were higher than the cut off values. (ANOVA, p < 0.05). The mean scores of the variables of SF-36 were lower than the national average scores. Exaggerated sensitivity to mild bodily sensations had significant positive correlations with psychological distress, anxiety, depression and poor QOL. (Pearson, p < 0.05). Females had significantly more exaggerated physical symptoms than males. We did not observe a female predominance among anxious and depressed patients. The tests mean scores were similar between the two forms of IBD and were not associated with age, duration of disease, disease subtype.
We demonstrate that exaggeration of physical symptoms worse the QOL, depression and anxiety regardless of disease type. And female patients are the most affected group. This exaggerated physical symptoms induce a higher level of symptom severity, more reporting of unexplained physical symptoms. We believe that assesment of psychological disorders along with approciate management will improve the patient reported outcome measures and the quality of care provided to our patients.