P247 Anxiety and depression in newly diagnosed patients with Inflammatory Bowel Disease – Results from the IBSEN III study
Authors: Johansen I , Hagen M , Løkkeberg S T , Kristensen V A , Høivik M L , Lund C , Strande V , Glad I F , Bengtson M B , Aabrekk T B , Cetinkaya R , Detlie T E , Frigstad S O , Medhus A W , Holten K I A , Hovde Ø , Olsen B C , Perminov G , Ricanek P , Vatn S , Huppertz-Hauss G , Torp R , Jelsness-Jørgensen L P , Opheim R 
Published: January 2024

Abstract

Background
There are few studies assessing anxiety and depression in newly diagnosed patients with inflammatory bowel disease (IBD). The purpose of this study was to determine the prevalence of anxiety and depression in patients newly diagnosed with Crohn`s disease (CD) and ulcerative colitis (UC), and to compare anxiety and depression with the Norwegian general population.

Methods
Patients (≥18 years) were included from the Inflammatory Bowel Disease in South-Eastern Norway (IBSEN III) study, a large prospective observational inception cohort. Prevalences of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), where a dimensional sub-score of ≥8 was indicative of possible cases of anxiety (HADS-A) and depression (HADS-D). Data on the general population is retrieved from the Trøndelag Health Study (the HUNT Study), a large, population-based cohort study in Norway (N= 56041). Robust regression analyses were performed to compare HADS scores in the patients with IBD to individuals from the general population, adjusted for age and education. Prevalences of both depression and anxiety are estimated using the dichotomised HADS scores.

Results
Of the 1509 patients with a verified IBD diagnosis, 938 patients aged ≥ 18 years (62.1%) completed the HADS questionnaire (CD, 297 (31.7%), UC, 641 (68.3%). In the general population there were n= 41242 respondents of the HADS. The prevalence of anxiety in CD was 37.4% (95% CI [0.32; 0.43]) compared with 32.1% in UC (95% CI [0.28; 0.35]) and prevalence of depression was 21.9% in CD (95% CI [0.17; 0.27]), compared with 16.8% in UC (95% CI [0.14; 0.20]). In the general population, the prevalence of anxiety was 17.9 % (95% CI [0.18; 0.18]), and the prevalence of depression was 9.6% (95% CI [0.09; 0.10]), both significantly lower compared with the patients with CD and UC.
Compared with the general population, male patients with CD scored significantly higher, 2.9 points higher (95% CI [2.5;3.4]) on HADS-A and 1.3 points higher (95% CI [ 0.9; 1.8]) on HADS-D. Male patients with UC scored significantly higher on HADS-A (B = 2.5, 95% CI [2.1; 2.8]) and HADS-D (B= 0.7, 95% CI [0.4; 1.0]). Female patients with CD scored significantly higher on HADS-D, B= 0.8 (95% CI [0.3;1.3]). No statistically difference between females with UC and females in the general population was found.

Conclusion
Anxiety and depression are prevalent in patients newly diagnosed with IBD, and significantly more prevalent in patients compared with the general population. Male patients especially, had significantly higher HADS scores compared with the general population. The results indicate considerable psychological impact of IBD in newly diagnosed patients.