Background
Psychological factors such as stress, anxiety and depression are frequently related to IBD. However, there are few studies of these factors in patients with a new diagnosis of IBD. The aim of the present study is to test the psychological burden in patients with a recent diagnosis of IBD and to check if there are differences between Crohn’s disease (CD) and Ulcerative Colitis (UC).
Methods
Prospective, multi-center, observational study in patients with a new diagnosis of IBD (<6 months). The patients were recruited from 4 different Spanish hospitals. Patients were evaluated using the Holmes and Rae social readjustment rating (SRRS), the hospital anxiety and depression scale (HAD), Scale of Stress Perceived by the Disease (EAE) and quality of life questionnaire for patients with inflammatory bowel disease (IBDQ).
Results
We included 156 patients, 69 (44.2%) women and 87 men (55.8%); 80 (51.3%) CD and 76 (48.7%) UC, mean age 42.3 (SD 16.21) years. The sample was homogeneous between groups in relation to socio-demographic variables. In the total sample a 60.9% of the patient associated the onset of the disease with a stressful life event. Patients with CD showed a greater psychological impact on measures of anxiety, CD 48.8% - UC 25%, OR 2.8, (95% CI 1.4–5.6), depression CD 25% - UC 9.2%, OR 3.2 (95%CI 1.2–8.3) and stressful life events CD 86.3% - UC 67.1%, OR 3 (95%CI 1.3–6.8). In terms of general quality of life, 82.9% of UC patients showed high scores compared to 57.5% of CD patients, OR 0.27 (95%CI 0.13–0.58). In the IBDQ domains, CD patients had lower scores than UC patients, except in the digestive domain, where scores were similar. In the scale of perceived stress due to the disease, both groups showed elevated values (CD 86.3% - UC 80.3%).
Conclusion
Patients with a recent diagnosis of CD are more emotionally affected and have a poorer quality of life at the beginning of the diagnosis when compared to patients with UC. Both have high scores in perceived stress due to the disease. They perceive the disease at diagnosis as a highly stressful life event, so this should be considered to promote interventions (perhaps disease-specific) aimed at alleviating that stress and preventing it from interfering with the course of the disease.
Background
Patients with inflammatory bowel disease (IBD) are vulnerable to some psychological disorders. Here we describe the psychological impact of a COVID-19 pandemic lockdown in patients with IBD.
Methods
This multicenter prospective cohort study included 145 patients recently diagnosed with IBD. Data on clinical and demographic characteristics, anxiety and depression (Hospital Anxiety and Depression Scale), and IBD activity (the Modified Harvey Bradshaw Index for CD and Simple Clinical Colitis Activity Index for CU) were collected in two telephone surveys, during and after the first COVID-19 lockdown in Spain. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.
Results
During lockdown, 33.1% and 24.1% scored high on the anxiety and depression scales, respectively. Independent factors related to anxiety (all values ORs; 95% CIs) during lockdown were female sex (2; 1.2–5.4) and IBD activity (4.3; 1.8–10.4). Factors related to depression were comorbidity (3.3; 1.1–9.8), IBD activity (6; 1.9–18.1), use of biologics (2.9; 1.1–7.6), and living alone or with one person (3.1; 1.2–8.2). After lockdown, anxiety and depression symptoms showed significant improvement, with 24.8% and 15.2% having high scores for anxiety and depression, respectively. Factors related to post-lockdown anxiety were female sex (2.5; 1.01–6.3), Crohn’s disease (3.3; 1.3–8.5), and active IBD (4.1; 1.2–13.7). Factors associated with depression were previous history of mood and/or anxiety disorders (6.3; 1.6–24.9), active IBD (7.5; 2.1–26.8), and steroid use (6.4; 1.4–29).
Conclusion
Lockdown during the COVID-19 pandemic had a significant psychological impact in patients with IBD. Disease activity was related to the presence of anxiety and depression symptoms during and after lockdown.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.