P098 Influence of psychological variables on health-related quality of life on ulcerative colitis patients

Abstract

Background: Inflammatory Bowel Disease (IBD) by its clinical features, determines a serious impairment in health-related quality of life (HRQOL). One of the major determinants of quality of life is the activity of the disease; however, psychological factors may also influence it. The aim of this study was to assess the influence of psychological factors (stress, coping and anxiety and depression) on HRQOL in ulcerative colitis (UC). Methods: A cross-sectional, prospective study with consecutive patient recruitment was designed. The case-studies were consecutive patients with UC who attended a monographic IBD Unit for 36 months. Remission was defined as a Mayo score 2. To assess quality of life we used the IBDQ-36 questionnaire, which included five dimensions (Bowel Symptoms, Systemic Symptoms, Functional Impairment, Social Impairment, and Emotional Function). Total scores range from 36 to 252. We also used the SF-36, which included 8 scales (General Health, Physical Functioning, Role-Physical, Vitality, Role-Emotional, Social Functioning, Bodily Pain, and Mental Health). Total scores range from 0 to 100. In both cases, higher scores indicate better HRQOL. Stress was assessed by the Perceived Stress scale (range 0 56, a higher score corresponds to a higher level of stress). Coping strategies were assessed with the COPE scale which consists of 3 scales: problem-focused coping, emotion-focused coping and avoidant coping. The HADS questionnaire was used to evaluate anxiety and depression symptoms. Multivariate regression was also used to estimate the factors associated to HRQOL. Results: 470 patients were consecutively recruited, 234 (49.8%) were female and 195 (41.5%) were in relapse. Multivariate regression analysis showed that psychological variables were risk factors for an impaired quality of life in all scales, after taking into account other relevant sociodemographic and clinical variables. Stress was a risk factor for an impaired quality of life in all scales of IBDQ and in all scales of SF-36 except in Physical Function (p = 0.461), Role-Physical (p = 0.115) and General Health (p = 0.080) dimensions; coping was a risk factor only for Systemic Symptoms (IBDQ) (p = 0.006) and Physical Function (SF-36) (p = 0.036); and anxiety or depression were risk factors for all assessed scales. Conclusions: This study shows that psychological variables had an important impact on HRQOL, mainly stress and psychological morbidity, and it should be taken into account when caring for UC patients.