Search

P236 Low Social support and distinct anxiety as a crucial feature in depressive IBD patients

Klaus, J.(1);Kretschmer, M.(1);Schulte, L.(1);Kaltenbach, T.(1);Rauschek, L.(1);Sularz, M.(1);

(1)University Hospital Ulm, Departement of Internal Medicine I, Ulm, Germany

Background

Depression is a common comorbidity of Inflammatory Bowel Disease (IBD) which leads to deterioration of the state of disease. The physician needs to know which psychiatric and temperamental characteristics have to be met in order to adapt his treatment to depressive patients. Therefore we compared patients with elevated depressive scores to those with normal scores.

Methods

291 IBD patients in 3 specialized IBD clinics in Germany (Ulm, Blaubeuren, Biberach) answered an anonymous questionnaire on their disease itself, on socio-demographic parameters and 6 psychological tests (HADS, STAI-S, STAI-T, FSozU, Neo-FFI, BL-R).

Results

The questionnaire was completed by 139 (47,3%) male and 155 (52,7%) female patients, 185 (63,4%) with Crohn’s disease and 107 (36,6%) with ulcerative colitis. 229 patients (79,0%) had a normal depression score (=NormD) (HADS-D), 59 (21,0%) had a borderline to very severe elevated score (elevated depression score = ElevD).

We characterized ElevD patients with the aid of a personality test (Neo-FFI) as more neurotic (p<0.001), but less extroverted (p<0.001), open for experience (p=0.042), agreeable (p=0.004) and conscientious (p=0.001) than patients with NormD. The Hospital Anxiety and Depression Scale (HADS-D) revealed them as more anxious (p<0.001). This was confirmed by the State Trait Anxiety Inventory (STAI-S/-T) which showed ElevD patients to be more anxious as a state (p<0.001) and as a trait (p<0.001).

Moreover patients with ElevD percieve their social support as little as seen in the FSozU (p<0.001). In addition there are lower scores in the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) (p<0.001), the Complaints List (B-LR) (p<0.001) and the fact that most of the patients with ElevD had an active disease  (43 (75,4%)) of the group.

Conclusion

IBD patients with an elevated depression score are more neurotic and less extroverted, open for experience, agreeable and conscientious than other patients. They are anxious and have little social support combined with many complaints and low quality of life. To improve their situation or to prevent it, the treating physician needs to be more sensitive to the patient’s state of mind and inquire more about their general complaints and especially their social support system so he is able to intervene and optimize the quality of life.

Portal