CLINICAL AND PSYCHOEMOTIONAL PROFILE OF INFLAMMATORY BOWEL DISEASE PATIENTS IN RUSSIA

Significance. Inflammatory bowel diseases are chronic, relapsing conditions requiring continuous management by a multidisciplinary team. In 2021, the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE II) consensus emphasized that therapeutic endpoints in inflammatory bowel diseases should encompass not only disease remission but also improvements in patient-reported outcomes, specifically quality of life and psychological well-being. Previous investigations in Russia have consistently demonstrated a compromised quality of life and psychological distress in individuals with inflammatory bowel diseases. This underscores the need to explore the relationship between these factors and to identify potential targets for therapeutic interventions. Purpose. To evaluate the interplay between psychosocial characteristics, disease activity, and their associations in inflammatory bowel disease patients to identify potential targets for interventions, including telemedicine. Material and methods. A cross-sectional, observational study was conducted among patients with inflammatory bowel diseases. The following questionnaires were used to assess the parameters: the Harvey-Bradshaw Index, the Simple Clinical Colitis Activity Index, the World Health Organization Quality of Life questionnaire, the Short Inflammatory Bowel Disease Questionnaire, the Hospital Anxiety and Depression Scale, the Visceral Sensitivity Index, and the Toronto Alexithymia Scale. Results. The study sample comprised 102 participants (52 with ulcerative colitis and 50 with Crohn’s disease), with a median age of 34 years. Half of the cohort was in clinical remission. The analysis revealed that 43.8% of the inflammatory bowel disease patients had suboptimal quality of life, 92.8% had high scores on the visceral sensitivity index, and 49.7% showed signs of anxiety and depression. Furthermore, 34% of the patients in remission showed signs of anxiety and depression. The visceral sensitivity index showed a significant moderate correlation with depression and anxiety (Spearman’s ρ 0.58 and 0.63, respectively, p-value < 0.05). Anxiety and depression scores also showed a moderate positive correlation with each other (Spearman’s ρ 0.64, p-value < 0.05). A significant, moderate negative correlation was observed between health-related quality of life and the visceral sensitivity index (Spearman’s ρ -0.67, p-value < 0.05), depression scores (Spearman’s ρ -0.53, p-value < 0.05), and anxiety scores (Spearman’s ρ -0.61, p-value < 0.05). Moreover, the quality of life was associated not so much with the disease activity, but rather with the presence of anxiety, depression, and increased visceral sensitivity. Conclusion. Patients with inflammatory bowel diseases need to have their psycho-emotional wellbeing and visceral hypersensitivity addressed. This can be a starting point for various interventions, including the use of telemedicine technology. Keywords: Inflammatory bowel disease; Ulcerative colitis; Crohn’s disease; anxiety and depression; clinical activity; telemonitoring.