P763 Role of quality of life in patients with Inflammatory Bowel Disease
Kaltenbach, T.(1)*;Schulte, L.A.(1);Kranzeder, A.(2);Klaus, J.(1);Sularz, M.(1);
(1)Innere Medizin I, Uniklinik Ulm, Ulm, Germany;(2)Psychosomatische Klinik, Uniklinik Ulm, Ulm, Germany;
Complaints like diarrhea, incontinence, frequent hospitalizations etc. can affect quality of life (QoL) in IBD patients (IBDP). QoL plays a central role in patient care. We investigated in which aspects patients with high quality of life (HQL) differ from patients with low quality of life (LQL).
This study was based on an anonymous questionnaire. IBDP of specialized outpatient clinics in three hospitals in Germany participated. Using questions about IBD/ lifestyle, disease activity (Harvey-Bradshaw-Index (HBI)/ Partial Mayo Score (PMS)) and psychological tests (Hospital Anxiety and Depression Scale (HADS), State-Trait-Anxiety Inventory (STAI), Social Support Questionnaire (F-SozU), Complaints-list (BL-R'), NEO-Five-Factor Inventory (NEO-FFI), differences between IBDP with HQL (SIBDQ≥50) vs. LQL (SIBDQ<50) were investigated.
Overall, 103 (36%) patients had LQL and 183 (64%) had HQL. In general, LQL patients are more likely to be female (p=0.013), to worry about course of disease (p<0.001), to engage in irregular or no exercise (p=0.044), to have anal discomfort (p<0.001), to have extraintestinal symptoms, such as joint (p<0.001) or eye (p=0.004) disorders, and they are more likely to be taking cortisone (p<0.001).Furthermore LQL patients have higher number of general complaints (p<0.001) and are more often in active state of disease (HBI/CAI) (p<0.001 / p<0.001) or have higher disease activity than HQL patients. LQL patients rated the effect of their current medication poorer (p<0.001).Investigation of psychological parameters showed that LQL patients had higher scores on depression scale (p<0.001) and anxiety scale (p<0.001) of HADS-D. Both trait anxiety (p<0.001) and state anxiety (p<0.001) of STAI are significantly higher in LQL patients and they experience less social support (p=0.011). LQL patients are particularly likely to exhibit the personality trait neuroticism (p<0.001) in NEO-FFI, whereas HQL patients exhibit extraversion (p<0.001) and conscientiousness (p=0.007).
IBD patients with LQL differ from IBD patients with HQL in several factors. Inter alia, concerning disease in terms of higher disease activity, poorer effect of medication and additional extraintestinal manifestations. But also in terms of psychological factors such as anxiousness, depressiveness, and regarding extend of social support. By paying attention to and working on these factors affecting QOL physician and IBD-patient may improve this very important therapeutic goal together.