P210 Depression and anxiety disorders impact in the quality of life of patients with inflammatory bowel disease
J. Yamamoto-Furusho1, K. Bozada-Gutiérrez1, A. Sarmiento-Aguilar1, A. Fresan-Orellana2, P. Arguelles-Castro3, M. Garcia-Alanis3
1IBD Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Medicas y Nutricion, Gastroenterology, Mexico, Mexico, 2National Institute of Psychiatry Ramón de la Fuente Muñíz, Sub-direction of Clinical Research, Mexico, Mexico, 3Instituto Nacional de Ciencias Medicas y Nutricion, Psychiatry, Mexico, Mexico
The relationship among anxiety, depression and quality of life (QoL) in inflammatory bowel disease (IBD) patients can be influenced by multiple factors, for instance, social isolation, difficult economic state and maladaptive coping strategies can be associated with IBD relapses and the need of surgical treatment of life. The aim of the study was to determinate the levels of sensitivity and specificity of the Anxiety and Hospital Depression Scale (HADS), and explore the quality of life in patients with inflammatory bowel disease (IBD) with depression and anxiety.
This is a case–control study of 104 adult patients with diagnosis of IBD between the period of August 2017 to February 2018. All patients answered a self-administered questionnaire (HADs) that includes 14 interleaved items, 7 of which assess for anxiety symptoms and the other 7 depression symptoms. Each patient received psychiatric intervention with Structured Clinical Interview for DSM (SCID-I) instrument as a gold standard to stablish the cut-off points of HADS. Quality of life was evaluated with IBDQ-32. The statistical analysis was performed in SPSS V. 21.0.
According to the SCID-I, 24.0% of the patients had a depressive disorder characterised by major depressive disorder (84.0%) and dystymia (16%). A similar proportion of patients (20.2%) were diagnosed from an anxiety disorder such as generalised anxiety disorder in 76.2% and panic disorder in 38.1%. Using the already validated HADS Mexican version for patients with IBD, the total score for the depression dimension was 4.1 + 3.6 while for the anxiety dimension the total scoring was 5.4 + 3.8. With these scores and the SCID-I, the ROC curves for both psychiatric entities showed an adequate discriminative capacity of the HADS-Anxiety dimension (AUC = 0.84, 95% CI = 0.76−0.92) with a limited discriminability of the HADS-Depression dimension (AUC = 0.58, 95% CI = 0.46–0.70) using the proposed scoring of 8 as a cut-off point. From the four dimensions assessed in the IBDQ-32, the dimension of systemic symptoms had a high percentage of moderate and high affectation (34.6%) while less than 30% reported these levels of affectation in the dimensions of bowel symptoms (25.0%), emotional (29.8%) and social functioning (18.3%).
Anxiety and depression impacts negatively in the quality of life in Mexican patients with IBD. The Mexican version of HADS had good internal consistency and external validity, with favourable sensitivity and specificity for identifying cases of anxiety and depression in patients with IBD.