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N18 Mood disorders in a IBD population: a single-centre cohort

G. Lorenzon*1, A. Dessì1, C. Marinelli1, A. Rigo1, S. Facchin1, M. Inferrera1, R. D'Incà1, B. Barberio1, E. V. Savarino1, F. Zingone1

1Azienda Ospedaliera di Padova, Padova, Italy

Background

Chronic medical conditions, such as inflammatory bowel diseases(IBD),have been associated with impaired quality of life (QoL) and the presence of mood disorders compared with the general population. The aim of this observational study was to evaluate in a single-centre cohort of IBD patients: QoL, state and trait anxiety, depression and alexithymia.

Methods

Consecutive adult IBD outpatients from January to March 2018 were enrolled in the study. Main inclusion criteria were: confirmed diagnosis of Crohn’s disease (CD) or ulcerative colitis (UC) from at least 1 year and age between 18 and 70 years. Disease activity was evaluated by the Harvey–Bradshaw Index (HBI) for CD and the partial Mayo Score (pMS) for UC. Quality of life was evaluated with the SF36 and the results summarised in the physical and mental component scales (PCS and MCS). The PCS and MCS composite means and standard deviations (SD) are 50 ± 10 for the U.S. general population. Anxiety was evaluated with the State-Trait Anxiety Inventory which consists of two axes (Year 1 for state anxiety and Year 2 for trait anxiety; STAI scores >40: clinically significant symptoms of anxiety); depression was measured with the Beck Depression Inventory-II; alexithymia was investigated through the TAS-20.

Results

48 patients were enrolled (M/F 26/22, mean age at test 39 (SD 13.6) years; mean time from diagnosis 11.5 (SD 8.2), CD/UC 32/16). Thirteen of our patients had active disease at the time of the study and 20 was on biologic therapy. The mean PCS value was 50.3 (SD 11.9) and the mean MCS value was 40.15 (SD 7.60). Twenty patients (41.7%) had a pathological STAI1 (existing anxiety) and 25 (52.1%) a pathological STAI 2 (a predisposition to anxious reactions as a personality characteristic). Thirty-three (68.7%) had minimal depression while only one (2.1%) was severely depressed. Six patients (12.5%) reported borderline alexithymia and four clear alexithymia (8.3%). PCS and MCS scores were negatively correlated with depression and anxiety scores (worse quality of life in term of physical and mental aspects, worse depression and anxiety) while they were not related to alexithymia. No correlation was found between scales used and age at test, time from diagnosis and pMS. Instead, we found a relationship between HBI and all scales: presence of depression (r = 0.57, p = 0.0007), state anxiety (r = 0.4, p = 0.02), trait anxiety (r = 0.5, p = 0.003), alexithymia (r = 0.34, p = 0.05), mental scale (r = −0.54, p = 0.004) and physical scale (r = −0.5, p = 0.004). QoL and mood disorders were not influenced by the use of biologics or disease type(CD or UC.

Conclusion

Mood disorders affect IBD patients at any age and independently from the therapy used or the time from diagnosis. More attention should be given to the psychological aspects of IBD patients to improve their QoL.