P076  IBD Patients Treated for Depression and Anxiety May Be More Compliant with Surveillance Colonoscopies than Those Who Are Untreated

P076  IBD Patients Treated for Depression and Anxiety May Be More Compliant with Surveillance Colonoscopies than Those Who Are Untreated

 

Dharia Ishaan1, Belfaqeeh Omar1, Borum Marie1
1 George Washington University School of Medicine, Washington, United States

BACKGROUND: Multiple studies have established a relationship between psychological disease and gastrointestinal issues. The rate of depression and/or anxiety in inflammatory bowel disease (IBD) has been found to range from approximately 30% during remission to 60-80% during relapse. Concurrent psychological disease has been reported to impact the clinical course of IBD and speculated to affect compliance with colonoscopy surveillance. However, it is uncertain if treatment of depression and anxiety influences adherence to colonoscopies. This study evaluated compliance with surveillance colonoscopy by IBD patients with depression and anxiety.

METHODS: A retrospective chart review of all IBD patients seen at a single, urban academic medical center during a 3-year period was completed. Patients were then divided into one of two groups—those who had a diagnosis of depression and/or anxiety, and those who did not. Individuals with depression and/or anxiety were further divided into patients who were currently on an anti-depressant or anti-anxiolytic and those who were not. Patients were considered colonoscopy compliant if a colonoscopy had been performed 8 years after initial diagnosis or within 3 years of the previous one. Chi-square analyses were conducted with significance set at p-value of 0.05.

RESULTS: 162 IBD patients were included in this study. 30 (19%) patients were diagnosed with depression and / or anxiety. 20 of the 30 (67%) patients with depression and/or anxiety and 83 of 132 (63%) patients without depression and /or anxiety were compliant with their screening colonoscopy. There was no significant difference (p=0.6971) in colonoscopy compliance between these groups.
Of the 30 patients with depression and/or anxiety, 27 were on an anti-depressant or anti-anxiolytic. There was a significant difference (p=0.009) between the rate at which the 20 of the 27 (74%) patients on medications and 0 of the 3 (0%) patients not taking medications were compliant with their colonoscopy.

CONCLUSION(S): While there are studies that have assessed reasons for non-compliance with colonoscopies in IBD patients, there is little research that has evaluated the direct effects of psychological illness on colonoscopy compliance. 1 Prior to this study, our hypothesis was that IBD patients with depression or anxiety were more likely to be non-compliant with their colonoscopies. 2 While this study’s sample size was small, there was no significant difference in the rate of colonoscopy compliance based on the presence of depression or anxiety. However, patients who had untreated depression or anxiety were less likely to be compliant with their colonoscopy. While further studies with larger sample
sizes are needed, this study suggests that simply having a diagnosis of depression or anxiety does not significantly affect an IBD patient’s compliance with surveillance colonoscopies.