Symptoms of anxiety and depression are independently associated with inflammatory bowel disease-related disability

Background: Inflammatory bowel disease (IBD) frequently results in disability. The relevance of psychological effects in causing disability, and whether disability occurs similarly in non-Western cohorts is as yet unknown. Aim: We assessed the relationship between symptoms of anxiety and depression, quality of life and disability in a Singaporean IBD cohort and their predictors. Methods: Cross-sectional study. We assessed consecutive IBD subjects' IBD-Disability Index (IBD-DI), Hospital Anxiety and Depression Scale (HADS), and IBD questionnaire (IBDQ). Clinical and demographic variables were collected. Non -parametric statistical analyses were performed. Independent predictors of disability were identified through multivariate logistic regression. Results: 200 consecutive subjects were recruited (males: 69%; median age: 43.8 (+/- 15.4) years; 95 had Crohn's disease (CD), 105 had ulcerative colitis (UC); median IBD duration: 10.8 (+/- 9.0) years.) 27% of the cohort had anxiety and/or depression, which worsened disability (IBD-DI: 9 (+/- 14) with anxiety vs 6 (+/- 13) without anxiety, P < 0.001; 12 (+/- 16) with depression vs 5 (+/- 13) without depression, P < 0.001). Age at diagnosis, use of prednisolone, stricturing CD and active IBD were significant predictors of disability. IBDQ strongly correlated with IBD-DI(r(s) = 0.82, P < 0.01). Conclusion: Symptoms of anxiety and depression were common in this Asian cohort of IBD and were strongly associated with IBD-related disability. Recognizing psychological issues contributing to disability in IBD is important to ensure holistic care and appropriate treatment. (C) 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.