Anxiety, depression, and disability in patients with inflammatory bowel disease.

Abstract

Background and Aim: Anxiety, depression, and disability are common in patients with inflammatory bowel disease (IBD). The aim of this study was to assess the underlying disability, anxiety, and depression in a combined IBD cohort. Secondary aims were to analyze the clinical predictors of anxiety and depression; assess the correlation between the Hospital Anxiety and Depression Scale (HADS) with the IBD Disability Index (IBD-DI); and assess the change in anxiety and depression with a repeat HADS questionnaire. Method(s): This prospective observational study included patients with IBD from two tertiary referral centers. Baseline characteristics were recorded for all patients. Disability, anxiety, and depression were measured using the IBD-DI and HADS questionnaires. HADS and a subjective measure of disease control were repeated after 1 year. Result(s): A total of 150 patients were included in this study, of whom 61 had ulcerative colitis (UC) and 89 had Crohn's disease (CD). The prevalences of disability, anxiety, and depression were 71%, 41%, and 23%, respectively. Anxiety was associated with disability and depression (P = 0.003 and P < 0.001, respectively). Depression was associated with disability, anxiety, and active disease (P = 0.003, P < 0.001, and P = 0.003, respectively). Disability was associated with depression, anxiety, and active disease (P = 0.003, P < 0.001, and P < 0.001, respectively). Anxiety, depression, and psychological distress were all associated with disability (P < 0.001). Disability was associated with active disease (P = 0.004). There was less psychological distress on follow-up after 1 year (P = 0.009), but overall prevalences of anxiety and depression remained similar. Conclusion(s): Disability is associated with active IBD. In addition to traditional measures of disease control, measurement of disability, depression, and anxiety through objective measures would allow for an improved global assessment of disease, to better identify those patients needing more support from the IBD multidisciplinary team.