N03 Disease burden of patients with inflammatory bowel disease from the viewpoint of QOL and depression

Abstract

Abstract Background Inflammatory bowel disease (IBD) can lead to a decreased quality of life (QOL), and mental care is necessary for patients with IBD. Disease burden (patient burden caused by a disease) attracts attention from the viewpoint of QOL and mental care. However, the relationship between QOL and depression in patients with IBD has not yet been adequately researched. Therefore, we aimed to examine disease burden and the relationship between QOL and depression in Japanese patients with IBD. Methods The present study enrolled 200 patients with ulcerative colitis (UC) and 31 patients with Crohn’s disease (CD) who were treated in Aoyama Clinic between July 2018 and September 2018. We evaluated QOL using a 24-item questionnaire which we made originally based on previous studies. Next, we evaluated depression according to the Patient Health Questionnaire-9 (PHQ-9). Partial Mayo score of less than 2 points indicated UC remission, whereas the CDAI score of less than 150 points denoted CD remission. We analysed the difference in QOL and depression scores between UC and CD, the age or sex, the disease activity, and the time since diagnosis using chi-square test. The association between QOL and depression scores was analysed using Spearman’s rank correlation coefficient. This study was approved by the Aoyama Clinic Ethical Review Board (2018-1). Results Decrease in QOL (scale ≥ 7) and depression (PHQ-9 score ≥ 10) in active phase were higher than those in remission phase (decrease in QOL among UC in active phase: 6.3 ± 4.8, among UC remission phase: 2.2 ± 3.4; p < 0.05, among CD in active phase: 3.8 ± 3.3, among CD remission phase: 2.3 ± 2.7, depression score among UC in active phase: 4.9 ± 4.8, among UC remission phase: 3.1 ± 3.8; p < 0.05, among CD in active phase: 3.8 ± 3.3, among CD remission phase: 2.3 ± 2.7), but no difference was noted in the age or sex and disease duration. Meanwhile, the QOL decrease and depression score in UC as a whole (r = 0.397, p = 0.000) positively correlated. In remission, the correlation in women (r = 0.385, p = 0.000) was considerably higher than that in men (r = 0.290, p = 0.007). Factors regarding QOL decrease in remission were carcinogenesis, defecation frequency, surgery, economic matters, relapse, lavatory, and heredity. Conclusion Even in UC remission and when QOL decrease is mild, women strongly feel a mental burden; thus, they should be given the appropriate care. Disease burden including QOL and mental care is an important point that medical staff and physicians should deal with together.