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PTH-080 Do we Need to Screen our Inflammatory Bowel Disease (IBD) Patients FOR Depression: The Prevalence and Severity of Depression within a Typical District General Cohort of IBD Patients
  1. N Swart1,
  2. D Wellsted1,
  3. K Lithgo2,
  4. T Price2,
  5. M W Johnson2
  1. 1Centre for Lifespan and Chronic Illness Research, University of Hertfordshire, Hatfield
  2. 2Gastroenterology, Luton & Dunstable University Hospital, Luton, UK

Abstract

Introduction Depression is believed to occur in 15 to 30% of IBD patients, in which suicide is not an uncommon ideation. Some researchers believe that psychiatric illness may have an aetiological role to play in the onset of inflammatory bowel disease (IBD), as the incidence of depression seems to be concentrated in the year before and after the initial diagnosis is made.

Objectives To assess the true prevalence and severity of depression within our inflammatory bowel disease patients.

Methods 2400 patients with IBD in the Luton & Dunstable catchment were invited to participate in a web-based quality of life assessment, with the option to request a paper copy. All patients were deemed eligible provided they were over 18 and under 90 years of age, with no major learning difficulties or pre-existing serious mental disorders. The well validated 9-item self-report “Patient Health Questionnaire” (PHQ) was used. The PHQ-9 has a minimum possible score of 0 and a maximum possible score of 27. Scores of 5, 10, 15, and 20 represent cut-off scores for mild, moderate, moderately severe, and severe depression.

Results 245 patients completed the assessment (43% male; mean age = 53, SD = 17). 45% had Ulcerative Colitis, 45% had Crohn’s Disease and 10% had an alternative form of IBD (e.g. Proctitis, Lymphocytic Colitis or Collagenous Colitis). The ethnic mix in the responding cohort was 91% Caucasian, 6% Asian, 2% Mixed and 1% was not stated. The sample had a mean score of 7.8 (CI = 7 – 8.6). 98 (40%) of patients’ scores reflected “no depression”; 64 (26%) reflected “mild depression”; 33 (14%) reflected “moderate depression”; 36 (15%) reflected “moderately severe depression”; 12 (5%) of scores reflected “severe depression”.

Conclusion 20% of our responding IBD patients were shown to have clinically significant levels of depression (moderately severe + severe), with 5% demonstrating scores suggestive of severe depression (1% expressing suicidal ideation). Relapse rates are known to be closely correlated with the severity of depression, and yet very few are on active treatment or review for this. The prevalence and severity of depression in our cohort of responding IBD patients supports the argument for screening all new IBD patients in order to optimise clinical well-being and treatment efficacy.

Disclosure of Interest None Declared.

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