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P196 High frequency of undiagnosed mental illness in inflammatory bowel diseases

I. MARAFINI1, L. Longo1, S. Salvatori1, D. Miri Lavasani2, F. Pianigiani1, E. Calabrese1, R. Rossi1, A. Siracusano1, G. Di Lorenzo2, G. Monteleone1

1Department of Systems Medicine- Gastroenterology Unit, University of Rome ‘Tor Vergata’, Roma, Italy, 2Department of Systems Medicine- Psychiatric Unit, University of Rome ‘Tor Vergata’, Roma, Italy

Background

Inflammatory bowel diseases (IBD) are associated with mental disorders, which can negatively influence the course of IBD. Nonetheless, psychiatric disorder comorbidities (PDCs) remain undiagnosed in many IBD patients. The aim of this study was to assess the frequency of undiagnosed psychiatric comorbidities in IBD patients.

Methods

Two-hundred-thirty-seven adult IBD [136 Crohn’s disease (CD) and 101 with ulcerative colitis (UC)] outpatients were consecutively recruited in a single university hospital centre between January 2018 and June 2019. After the visit for IBD clinical evaluation, participants completed self-report questionnaires and then underwent a clinical interview by a trained psychiatrist.

Results

One-hundred-fourteen (48%) IBD patients had at least one undiagnosed psychiatric disorder. Forty-three (18%) patients presented a single PDC, 40 (16.8%) had two PDCs, 11 (4.6%) had 3 PDCs, 12 (5%) had 4 PDCs, 7 (2.9%) had 5 PDCs and 1 (0.4%) had 6 PDCs. PDCs were equally distributed among CD (72/136, 53%) and UC (42/101, 42%) patients. Mood disorders (54/114, 47%) and anxiety (27/114, 24%) disorders were the most common PDC; moreover, 23 (20%) patients suffered from post-traumatic stress disorder (PTSD), 3 (3%) had an obsessive-compulsive disorder, and 7 (6%) a substance abuse/dependence disorder. Fifty-nine per cent of IBD patients diagnosed with a psychiatric disorder during the study did not have a positive psychiatric anamnesis. PDCs were not related to activity, phenotype or localisation of IBD.

Conclusion

Psychiatric disorders are common in IBD but not related to activity, phenotype or localisation of bowel disease. Overall, these findings suggest the necessity to include psychiatric evaluation in the management of IBD patients.