Depression, anxiety, and stress among inflammatory bowel disease patients during COVID‐19: A UK cohort study

Abstract

Background and Aim Patients with chronic diseases are believed to be at increased risk of mental health conditions during the COVID‐19 pandemic. We aimed to assess the incidence of psychological morbidity in inflammatory bowel disease (IBD) patients during the COVID‐19 pandemic, explore for association with risk of severe COVID‐19 and other factors, and establish patients' interest in psychological support. Methods A survey including the Patient Health Questionnaire‐9, General Anxiety Disorder‐7, and Perceived Stress Scale tools for depression, anxiety, and stress was administered to IBD patients from a tertiary center in London, United Kingdom, in June 2020. Results Two hundred seventy‐four patients responded to the survey (57% response rate), with 271 (99%) completing it. Moderate–severe depression was observed in 61 (22.5%), while 49 (18%) had moderate–severe anxiety; 39 (14%) had both diagnoses. Mean (SD) stress score was 16.2 (7.4). There was no association between degree of severe COVID‐19 risk and psychological morbidity. Flare symptoms and fatigue were associated with worse psychological morbidity, while accessibility of information regarding COVID‐19 risk and reducing that risk was protective for depression (odds ratio [OR] 0.56 [0.33–0.94], P = 0.03), anxiety (OR 0.62 [0.4–0.96], P = 0.03), and stress (standardized β‐coefficient −0.15 [−0.28 to −0.03], P = 0.02). Seventy‐nine (30%) respondents were interested in receiving psychological support during the pandemic, while 200 (76%) expressed interest beyond the pandemic. Conclusions Although depression, anxiety, and stress among IBD patients during the pandemic were common, their frequency was similar to pre‐pandemic rates and recent general population levels. Ensuring easy access to personalized risk information with targeted psychological support may mitigate psychological burden as patients reintegrate into society and deal with future COVID‐19 waves.

The impact of restrictions on psychological outcomes in patients with inflammatory bowel disease on biological treatment during the coronavirus pandemic in Norway

“…In studies assessing depression with PHQ-9 in IBD populations before the pandemic, a prevalence between 25% and 34% was found [ 23 , 24 ]. Only 12.5% reported anxiety in our study, which is somewhat lower than findings in a hospital-based cohort in the United Kingdom that found a prevalence of 18% [ 22 ]. A study assessing anxiety with GAD-7 in an IBD population in 2018 found a prevalence of 21% [ 24 ].…”

“…One-fifth of patients reported major symptoms of depression. Our finding is in accordance with a rate of 22.5% in a newly published study that assessed depression with PHQ-9 in a hospital-based sample of IBD patients in the United Kingdom during the pandemic [ 22 ]. In studies assessing depression with PHQ-9 in IBD populations before the pandemic, a prevalence between 25% and 34% was found [ 23 , 24 ].…”

The impact of source and consumption of news on mental distress among inflammatory bowel disease patients during the COVID-19 pandemic

“…We have previously reported that during the early phase of the COVID-19 pandemic, persons with IBD were significantly distressed about access to needed care (eg, primary care provider, IBD medications) and were especially concerned about their family’s health, getting infected with COVID-19, and having an IBD flare. 35 , 36 In the early months of the pandemic, when there was little reliable information about the interaction of diseases and immune modifying therapies with COVID-19, individuals with IBD had elevated fear of worse outcomes if they were to get COVID-19 because of their IBD disease activity or their concomitant IBD therapy, 37 , 38 although at that informative and reliable data were limited. More recent evidence indicated only corticosteroids were associated with worse outcomes.…”

The impact of COVID‐19 on Japanese patients with eosinophilic gastrointestinal disorders during the vaccination era

“…Patients with asymptomatic COVID‐19 may have been missed in this study. Third, several studies have shown the psychological impact of COVID‐19 in patients with chronic diseases, such as inflammatory bowel diseases 35–37 . However, no data are available on this issue.…”