P187 Major Depression in patients with Ulcerative Colitis and its relationship with clinical activity.
Facanali, C.(1);Sobrado, C.W.(1);meirelles carregaro, B.(1);Borba, M.R.(1);Nahas, S.C.(1);
(1)University of São Paulo School of Medicine, Department of Gastroenterology and Division of Colorectal Surgery, Sao Paulo, Brazil;
Background
In the last decade, there has been an increase in manuscripts published around the world related to psychological aspects in patients with IBD, suggesting a relationship between depression and IBD. Depressive symptoms seem to be able to aggravate ulcerative colitis (UC)¹, however there is a need for a clearer characterization of the sample and disease activity²,³. The aim of the study is to estimate the prevalence of major depression (MD) in patients with UC and to evaluate its relationship with the clinical activity and other diseases characteristics.
Methods
From October 2020 to May 2021, 299 patients with UC were evaluated using the Patient Health Questionnaire-9 (PHQ-9) scale, where absent depressive symptoms range from 0-4 points, mild depressive symptoms 5-9, moderate depressive symptoms 10-14, moderately-severe depressive symptoms 15-20, severe depressive symptoms greater than 20. MD was defined by PHQ-9 ≥10.
Data were prospective analyzed,regarding socio-demographic characteristics, surgeries, current treatment; clinical activity and extent of disease were assessed by montreal classification. The association of characteristics with the MD risk was verified using chi-square tests or Fisher's exact tests or likelihood ratio, and quantitative characteristics were compared according to MD risk categories using Student's t-tests or Mann-Whitney tests. All statistical tests were performed with a 5% significance level.
Results
The prevalence of MD in UC patients was 35.8%. The main socio-demographic characteristics and MD risk are described in Figure 1. Figure 2 shows that, separately, sex, disease activity, hemoglobin and hematocrit statistically influenced the risk of MD (p < 0.05). There was no association between disease extension, surgeries performed along the disease course or current drug treatment with MD (p > 0.05).
Together, gender influenced the MD risk in UC patients, regardless of the other characteristics evaluated, with female patients having a 2.63 times the chance of MD than male patients (Odds Ratio [OR] 2.63. 95% confidence interval [CI] 1, 41-4.89; p 0.002).
Conclusion
Our study confirms the high risk of MD among UC patients and is significantly related to the disease clinical activity. Psychological assessment of UC patients, in addition to objective measures of disease activity as an integral part of IBD care, is necessary, aiming to help improve the quality of life and maintain remission.