P085 Primary sclerosing cholangitis in the course of inflammatory bowel disease in children

Abstract

available data suggests that alexithymia could be highly prevalent and independent from disease activity in patients with inflammatory bowel disease (IBD) and it could affect disease management and symptom perception, which may in turn have an impact on health-related quality of life (HRQOL). The aim of this study was to assess the influence of alexithymia on HRQOL in IBD patients. Methods: A cross-sectional, prospective study with consecutive patient recruitment was designed. The case-studies consisted of consecutive patients with IBD (Crohn’s disease (CD) and ulcerative colitis (UC)) who attended the monographic IBD Unit at the University Hospital of Santiago de Compostela, Spain, from January 2009 to June 2010. To assess quality of life we used The Inflammatory Bowel Disease Questionnaire (IBDQ), which is an instrument specifically designed to assess HRQOL in patients with UC and CD. This is a self-administered questionnaire consisting of 36 items, distributed into five dimensions (Bowel Symptoms, Systemic Symptoms, Functional Impairment, Social Impairment, and Emotional Function), which are scored from 1 to 7 in the Likert scale (corresponding to the worst and best functioning levels respectively). Total scores range from 36 to 252, with higher scores reflecting a better HRQOL. Alexithymia was assessed using the Toronto Alexithymia Scale (TAS-26). This consists of 26 items which are scored from 1 to 5 in the Likert scale. Total scores range from 26 to 130. A cut-off point of 74 is used to identify a subject as alexithymic. Multivariate logistic regression was also used to estimate the factors associated with lower than normal values in the IBDQ. Results: 484 patients agreed to participate and were consecutively recruited; 192 patients (39.7%) had CD, and 292 (60.3%) had UC. The percentage of alexithymic patients was 30.2% (95% CI: 26.0 35.0) of the total sample with no differences in terms of clinical activity or type of disease. Multivariate logistic regression analysis showed that alexithymia (OR = 3.34, 95% CI: 1.98 5.65), depressive symptoms (OR = 3.65, 95% CI: 1.89 7.08), and presence of a psychiatric disorder (OR = 2.3, 95% CI: 1.27 4.20) were risk factors for poor quality of life. Conclusions: This study shows a high prevalence of alexithymia in IBD. In addition, alexithymia is a significant predictor of HRQOL in patients with IBD.