P291 Longitudinal assessment of Illness Identity in patients with Inflammatory Bowel Disease

Abstract

Abstract Background The concept of Illness Identity (IID) describes the way a patient integrates a chronic illness into the self-concept and has been examined in several chronic diseases. We distinguish four IID dimensions: acceptance, enrichment, engulfment and rejection. In patients with Inflammatory Bowel Diseases (IBD) IID engulfment has been shown to be associated with quality of life (QoL) and important psychosocial factors like anxiety and depression. As IBD often show a relapsing course with varying disease activity and symptom burden, it is unclear whether IID is a stable concept or whether it changes over the disease course. Methods In 2018 we started to recruit patients with active Crohn´s Disease or Ulcerative Colitis before the beginning of a new therapy with biologics (t1) and did follow-up examinations 6- 12 months (t2) and 2-3 years (t3) after the baseline examination. Until now we were able to reassess 71 of 83 at t2 and 16 of 83 patients at t3 We assessed IID with the Illness Identity Questionnaire (Oris et al.). Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale and QoL was assessed with the IBDQ. We analysed correlations between these factors at t1, t2 and t3 and calculated linear mixed-effects models to analyse the stability of IID over time. Pearson correlation between changes in IID and changes in disease activity were also examined. Results IID engulfment is associated with poorer QoL (r= -0.696, p= 0.003) at t3. Higher anxiety scores are linked to poorer QoL (r= -0.630, p=0.009) and higher depression scores are linked to poorer QoL (r= -0.502, p= 0.048) at t3. In the linear mixed-effects models of IID dimensions we found no significant changes in IID over time (IID enrichment : mean difference of 1.03, p= 0.297; IID acceptance : mean difference of -0.19, p= 0.824; IID rejection : mean difference of 0.69, p= 0.259; IID engulfment : mean difference of -0.22, p= 0.771. Changes in IID engulfment correlated positively with changes in disease activity (r= 0.626; p = .0095), whereas no significant correlations were found for the other IID dimensions (Fig 1.)) Conclusion Our preliminary results suggest stability of IID in patients with IBD over a period of up to 3 years. These results confirm our previous findings, demonstrating that especially IID engulfment is linked with a poorer QoL and changes in IID engulfment correlate with changes in disease activity.