Psychological Effects and Medication Adherence among Korean Patients with Inflammatory Bowel Disease during the Coronavirus Disease 2019 Pandemic: A Single-Center Survey

Abstract

Background and Aim. This study evaluated the impact of coronavirus disease 2019 (COVID-19) on the mental health of inflammatory bowel disease (IBD) patients. We quantified anxiety, depression, and medication adherence among IBD patients through a single-center survey in South Korea during the COVID-19 pandemic. Methods. An electronic survey was made available to patients at the IBD clinic in Daejeon St. Mary’s hospital from July 2021 to September 2021. The validated Hospital Anxiety and Depression Scale (HADS) was used to assess depression and anxiety. The Korean version of the Medication Adherence Rating Scale (KMARS) questionnaire was used to assess medication adherence. Results. In total, 407 patients (56.5%; ulcerative colitis, 43.5%; Crohn’s disease) participated in the survey. Among the respondents, 14.5% showed significant anxiety and 26.3% showed significant depression. Female sex, presence of mental disease, unvaccinated status, and the presence of Crohn’s disease were associated with greater risks of anxiety and depression. Among medications, immunomodulators were associated with a greater risk of anxiety. In terms of KMARS, patients reported favorable medication adherence despite the psychological burden of the pandemic. The KMARS score was 7.3 ± 1.5 (mean ± SD) of 10.0 points. High anxiety and depression were associated with a slight decrease in medication adherence. Conclusions. COVID-19 has increased anxiety and depression among IBD patients, whose medication adherence has nevertheless remained good. Furthermore, anxiety and depression were found to have a negative correlation with adherence. Our results provide insights concerning psychological response and medication adherence among IBD patients in South Korea during the COVID-19 pandemic.

Hericium erinaceus, a medicinal fungus with a centuries-old history: Evidence in gastrointestinal diseases

“…Beyond that, the potential of H. erinaceus to intervene in the gut-brain axis could also be explored in patients with IBD, where the prevalence and impact on the disease course of anxiety-depressive disorders are not negligible[ 108 , 109 ]. In addition, factors leading to anxiety-depressive disorders can impact therapeutic adherence, as observed during the COVID-19 pandemic[ 110 , 111 ].…”

COVID-19 and Gastrointestinal Disease: Current Insights and Future Management

“…Unvaccinated status, female gender, and the presence of psychiatric illness were associated with greater risks of anxiety and depression. Immunomodulator use was associated with a higher risk of anxiety [ 6 ]. Clerbaux et al performed a literature review and found that SARS-CoV-2 could induce intestinal inflammation by binding to ACE2 and infecting intestinal bacteria [ 7 , 8 ].…”

Gut Feelings: The Psychological Impact of Inflammatory Bowel Disease

“…Despite initial concerns about their vulnerability to SARS-CoV-2 infection, it has been found that the risk of severe COVID-19 is not increased in IBD patients [ 7 ]. Nevertheless, the prevalence of depression and anxiety symptoms increased in IBD patients during the pandemic [ 8 ]. High anxiety and depression levels were associated with a slight decrease in medication adherence.…”