Quality of Life, Anxiety, Depression and Sexual Dysfunction in Patients With Chronic Intestinal Diseases

Abstract

BACKGROUND: "Quality of life" (QoL) has been emphasized to assess the impact of a disease and its treatment in the patient's life. The QoL of chronic patients is significantly impaired, and it can lead to psychological and social changes, engendering anxiety, depression and other injuries, including sexual dysfunction. The aim of this study is to compare the QoL, the presence of anxious and depressive symptoms, the frequency of female sexual dysfunction and erectile dysfunction, and patient's self-esteem in the following groups: Inflammatory Bowel Diseases (IBD), Functional Bowel Disorders (FBD), Colon Cancer (CC) and Control Group (CG). METHODS: Cross-sectional study with specific questionnaires application, approved in the Research Ethics Committee (n.1.356.518). Ninety-nine patients with IBD (43 with Ulcerative Colitis and 56 with Crohn's Disease), 35 with FBD (20 with Chronic Constipation and 13 with Irritable Bowel Syndrome), 33 with CC and 150 healthy controls were interviewed. The SF-36 questionnaire was used to evaluate the Quality of Life, the Hospital Anxiety and Depression Scale (HADS) to assess the presence of anxiety and depression, the Rosenberg Self-esteem Scale to study the patients' self-esteem, the International Index of Erectile Function to evaluate the erectile dysfunction and the Female Sexual Function Index to assess the female sexual dysfunction. Statistical: descriptive and association tests, p <0.05. RESULTS: The mean age was 38.89 (± 10.15) years in the IBD group; 46.77 (± 15.87) in FBD patients; 62.88 (± 11.46) years in the CC group and 36.26 (± 12.39) in the CG. There was a predominance of women in IBD (56.6%), in FBD (97.1%) and in control (67.33%) groups, p <0.0001. Men had a small predominance in the CC group (51.5%), p <0.0001. The quality of life was impaired in the FBD group, with a significant difference compared to IBD (p <0.001) and control groups (p <0.0001). The prevalence of anxiety was higher in FBD patients (77.1%) compared to IBD (47.5%), CC (34.4%) and CG (38.7%), P=0.0003 Depression prevalence was higher in FBD group (60%) compared to the others: CC (40.63%), IBD (24.2%) and CG (21.33%), P<0.0001. Patients had high self-esteem in the majority of cases: CG (96%), IBD (90.9%), CC (93.75%), except in FBD group (61.76%), P<0.0001. There was a high prevalence of Erectile Dysfunction in the sample: FBD (100%), CC (50%), IBD (27.9%) and CG (35.42%) with no difference among groups (P=0.19). The Female Sexual Dysfunction was more prevalent in CC group (100%) compared to the others FBD (66.67%), IBD (46.4%) and CG (33.33%), P<0.0001. CONCLUSION(S): Patients with FBD had a greater impairment in their quality of life compared to IBD and control groups, as well as a higher prevalence of mood disorders compared to patients with organic diseases and the CG. They also had lower rates of high self-esteem. The female sexual dysfunction was higher in CC compared to the others and no difference in erectile dysfunction rates between the groups was found.