Abstract
Objective Anxiety and depression have a negative influence in the quality of life. The aim of the study was to determinate the levels of sensitivity and specificity of the Anxiety and Hospital Depression Scale (HADS) and compare the quality of life in patients with inflammatory bowel disease (IBD) and depression or anxiety. Methods This study included 104 patients with diagnosis of IBD. Each patient received psychiatric intervention with SCID-I (Structured Clinical Interview for DSMIV Axis I Disorders) instrument as a gold standard to stablish the cut-off points of HADS. Quality of life was also evaluated with IBDQ-32. Demographic and clinical variables were collected. Results Most of the patients reported a high quality of life (73.1%, n = 76), while 25.0% (n = 26) express a moderate quality of life. The ROC curves for both psychiatric entities showed an adequate discriminative capacity of the HADS-anxiety dimension (AUC = 0.84, 95%CI = 0.76-0.92) with a limited discriminability of the HADS-depression dimension (AUC = 0.58, 95%CI = 0.46-0.70) using the proposed scoring of 8 as a cut-off point. Conclusions Anxiety and depression impact negatively in the quality of life in Mexican patients with IBD. The Mexican version of HADS had acceptable internal consistency and external validity, with moderate sensitivity and specificity for clearly identifying clinical cases of anxiety and depression in patients with IBD.
Highlights
Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition that produces damage in the gastrointestinal tract [1] characterized by a relapsing and remitting clinical course where abdominal pain, bloody stools, diarrhea, fever, and weight loss [2] can appear in their mildest form or worsen until the point of compromising life [3]
These actions allow the physician to refer IBD patients when it is appropriate to a mental health specialist [7], considering that the final goal of health providers dedicated to the treatment of IBD is to offer a multidisciplinary treatment that achieves clinical, endoscopic, biochemical, and histological remission with a better quality of life (QoL) and avoidance of disability [8]
For the measurement of the quality of life, the selfapplicable specific questionnaire Inflammatory Bowel Disease Questionnaire of 32 items (IBDQ-32) was used, where the information is grouped in 4 dimensions, having 32 questions that have to answer, selected the option that best suits the way they have felt in the last 2 weeks including the day of the instrument application
Summary
Anxiety and depression have a negative influence in the quality of life. The aim of the study was to determinate the levels of sensitivity and specificity of the Anxiety and Hospital Depression Scale (HADS) and compare the quality of life in patients with inflammatory bowel disease (IBD) and depression or anxiety. Each patient received psychiatric intervention with SCID-I (Structured Clinical Interview for DSMIV Axis I Disorders) instrument as a gold standard to stablish the cut-off points of HADS. Anxiety and depression impact negatively in the quality of life in Mexican patients with IBD. The Mexican version of HADS had acceptable internal consistency and external validity, with moderate sensitivity and specificity for clearly identifying clinical cases of anxiety and depression in patients with IBD
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