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P128 Depression, anxiety and stress among Inflammatory Bowel Disease patients during COVID-19: A UK cohort study

LuberMBBS Hons FRACP, R.(1);Duff, A.(1);Pavlidis, P.(1);Honap, S.(1);Meade, S.(1);Ray, S.(1);Anderson, S.(1);Mawdsley, J.(1);Samaan, M.(1);Irving, P.(1);

(1)Guy's and St Thomas' NHS Foundation Trust, Gastroenterology, London, United Kingdom

Background

Patients with chronic diseases, particularly those requiring immunosuppression, are thought to be at increased risk of poor mental health during the COVID-19 pandemic. However, few studies have assessed the mental health of such patients during the current or past pandemics.

We aimed to assess the incidence of depression, anxiety & stress in a cohort of inflammatory bowel disease (IBD) patients early during the COVID-19 pandemic, & explore for association with risk of severe COVID-19 based on British Society of Gastroenterology guidelines, & other factors.

Methods

A survey including the Patient Health Questionnaire-9, General Anxiety Disorder-7, & Perceived Stress Scale tools for depression, anxiety & stress, respectively, was administered to a cohort of IBD patients from a tertiary centre in London, United Kingdom, in June 2020.

Results

274 patients responded to the survey (57% response rate), including 54 low risk, 152 moderate risk, & 68 high risk for severe COVID-19. Moderate-severe depression was observed in 61 (22.5%), moderate-severe anxiety in 49 (18%), while 39 (14%) had both diagnoses (Table). Mean (SD) stress score was 16.2 (7.4). There was no association between degree of severe COVID-19 risk & psychological morbidity.  Flare symptoms & fatigue were associated with worse psychological morbidity across all measures, while accessibility of information regarding COVID-19 risk & reducing that risk was protective for depression (OR 0.56 [0.33-0.94], p=0.03), anxiety (OR 0.62 [0.4-0.96], p=0.03), & stress (standardized β-coefficient -0.15 [-0.28--0.03], p=0.02) (Figure). 79 (30%) respondents were interested in receiving psychological support during the pandemic, while 200 (76%) expressed interest beyond the pandemic.

Table: Depression, anxiety & stress, stratified by risk category

Low Risk (n=52)Moderate Risk (n=151)High Risk (n=68)Between groups p-valuep-value for trend
Depression
None-Mild, n (%)43 (82.6)120 (79.4)47 (69.1)0.560.06
Moderate-Severe, n (%)9 (17.3)31 (20.5)21 (30.8)
Anxiety
None-Mild, n (%)42 (80.7)127 (84.1)52 (76.5)0.800.58
Moderate-Severe, n (%)10 (19.2)24 (15.9)15 (22.1)
Perceived Stress Scale Score
Mean (SD)16.9 (7.7)15.6 (7.3)17 (7.6)0.300.69


Figure: Association between access to COVID-19 risk information & at least moderate depression (A), anxiety (B), & Perceived Stress Scale score (C)

Conclusion

Depression, anxiety & stress among IBD patients during the pandemic are common, however their frequency is similar to pre-pandemic rates & general population levels reported during the same period. Ensuring easy access to personalized risk information with targeted psychological support may mitigate psychological burden as patients reintegrate into society & deal with future COVID-19 waves or variants.

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