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P495 The interplay of biopsychosocial factors and quality of life in Inflammatory Bowel Diseases: a network analysis

Knödler, L.L.(1);Thomann, A.(1);Karthikeyan, S.(2);Atanasova, K.(3);Bernstein, C.(4);Ebert, M.(1);Lis, S.(3);Reindl, W.(1);

(1)University Medical Center Mannheim- Medical Faculty Mannheim- Heidelberg University, Department of Medicine II, Mannheim, Germany;(2)Institute of Psychiatric and Psychosomatic Psychotherapy- Medical Faculty Mannheim- Heidelberg University- Central Institute of Mental Health- Mannheim- Germany, Experimental Psychology, , Germany;(3)Institute of Psychiatric and Psychosomatic Psychotherapy- Medical Faculty Mannheim- Heidelberg University- Central Institute of Mental Health- Mannheim- Germany, Experimental Psychology, Mannheim, Germany;(4)Faculty of Medicine- University of Manitoba- Winnipeg- MP- Canada, Department of Gastroenterology, Winnipeg, Canada

Background

Quality of life (QoL) is one of the most relevant patient-reported outcomes in the treatment of patients with inflammatory bowel diseases (IBD), but does not only depend on disease activity. We aimed to investigate the interplay of biopsychosocial factors and their associations with QoL in patients IBD by using a network analytical approach (NA).

Methods

We measured QoL and anxiety, depression, illness identity, self-esteem, loneliness, childhood trauma, and visceral sensitivity with self-report questionnaires in two independent IBD-samples (sample 1: n=209, anonymous internet survey; sample 2: n=84, outpatients with active disease before the beginning of a biologic treatment). Additionally, fatigue, haemoglobin levels and response to biologic therapy (3-6 months after the first assessment) were assessed in sample 2. We estimated regularized partial correlation networks and conducted tests of accuracy and stability of the network parameters.

Results

In both samples, QoL had the strongest associations with visceral sensitivity and the illness identity dimension engulfment, a maladaptive integration of IBD into the ‘self’. QoL was uniquely associated with depressive symptoms and fatigue was an essential factor in this link (sample 2). Depression was the most central factor in the networks. Baseline depression scores were connected to response to biologic therapy in sample 2.



Conclusion

This is the first study using NA to assess the complex interplay between biopsychosocial factors and QoL in IBD. It reveals a comparable network structure in two independent samples emphasizing the importance of depression. Visceral sensitivity and engulfment connected most strongly to QoL. Beyond depression, visceral sensitivity and illness identity may be targetable characteristics to improve QoL in personalised holistic therapy in IBD.

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