Abstract
Abstract Background Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), can trigger the onset of depressive and anxiety symptoms. The evaluation of mental well-being in patients with a chronic medical condition is considered a good clinical practice and it is strongly recommended by the World Health Organization. Nevertheless, mental health is not routinely investigated in this context for several reasons, including lack of training by healthcare professionals, stigma associated to mental health and gender-relatedstereotypes. The objectives of our study were to assess the presence of depressive and anxiety symptoms inpatients affected by IBD using two simple validated questionnaires and to identify potential related factors, particularly gender differences. Methods We conducted a single center observational study evaluating anxiety and depressive symptoms in patients with IBD treated with biological therapy at the IBD Unit of Ospedale Policlinico of Milan during October 2022. We assessed depressive and anxiety symptoms using respectively the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) that are easy self-administered rating scales. Univariate analyses and regression models were applied for the purpose of the study. Results Among a total of 174 consecutive patients, 158 completed the questionnaires. The prevalence of moderate tosevere depression (PHQ-9 score > 9) in the total sample was 18.4%, and it was higher in CD than in UC (21% vs 9.7%). The prevalence of clinically significant anxiety symptoms (GAD-7 score > 9) was 24% (25.7% in CD and 19.3% in UC). Focusing on gender differences, similar prevalence of significant anxiety anddepression was observed between males (M) and females (F); respectively 18.6% M vs 17.6% F for depression (PHQ-9 > 9) and 22.2% M vs 25.4% F for anxiety (GAD-7 > 9). Of note, a relevant association was observed between younger age and higher GAD-7 (β =-0.639; p=0.021) and PHQ-9 (β =-0.604, p=0.055) scores. Conclusion Both males and females (especially younger) IBD patients in biological therapy are largely affected bysignificant depressive and anxiety symptoms. The administration of simple questionnaires like PHQ-9 andGAD-7 in routine clinical practice can facilitate early identification of patients requiring mental health support, this is crucial as psychiatric conditions can complicate the course of the disease and adherence to treatments.
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