Introduction Previous studies have suggested that 15 to 30% of inflammatory bowel disease (IBD) patients also suffer from anxiety. Whilst most gastroenterologists would feel confident in recognising and diagnosing florid steroid induced psychosis, much of the associated anxiety experienced by IBD patients goes undiagnosed and untreated. Disease severity, recurrent flares, poor treatment adherence, disability, unemployment status, and socio-economic deprivation are all believed to be associated with anxiety in these patients. The severity of anxiety also appears to be directly correlated to the physical morbidity and malnutrition risk.
Objectives To assess the true prevalence of anxiety within our IBD 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. Eligibility criteria required patients to be between 18 and 90 years of age, with no serious learning difficulties or pre-existing serious mental disorders. The well validated 7-item self-report “Generalised Anxiety Disorder (GAD) Questionnaire” was used. The GAD-7 has a minimum possible score of 0 and a maximum possible score of 21. Scores of 5, 10, and 15 represent cut-off scores for mild, moderate, and severe anxiety.
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 6.6 (CI = 5.9 – 7.4). 72% of patients’ scores reflected no anxiety or “mild anxiety”; 15% reflected “moderate anxiety”; and 13% reflected “severe anxiety”.
Conclusion 29% of our responding IBD patients were shown to have significant anxiety scores (moderate + severe), with 14% demonstrating severe anxiety levels. Despite the severity, few of these patients were receiving treatment or therapy for their condition. The GAD score is a simple and quick tool that can be used in clinic. Given that anxiety is believed to directly affect the clinical course of IBD, both the screening and treatment of this condition should be considered part of standard IBD medical care.
Disclosure of Interest None Declared.
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