The Lesson from the First Italian Lockdown: Impacts on Anxiety and Depressive Symptoms and Sleep Quality in Patients with Remission of Inflammatory Bowel Disease

Abstract

Background: During the COVID-19 pandemic in Italy, decisions were taken adopting restrictive legislative measures, such as the first half of 2020 lockdown. In those months, patients with inflammatory bowel disease have experienced social isolation and reduced access to health care. Objective: Our aim was to evaluate, in this condition, the presence of remission subgroups that were most impacted by the lockdown. Methods: In the midst of the first Italian lockdown, we recruited patients with remission inflammatory bowel disease administering an online questionnaire including patient demographics, the Beck Anxiety questionnaire Inventory, the Beck Depression Inventory questionnaire and the Pittsburg Sleep Quality Index, all validated standardized questionnaires for anxiety symptom levels, depression and sleep quality. Results: Our results showed how female patients (p<0.0001) with Crohn’s disease (p<0.001) experienced worse levels of anxiety symptoms. Female patients (p<0.0001), between 50 and 60 years of age (p=0.013) and with Crohn’s disease (p=0.047) experienced worse levels of depressive symptoms. Females experienced significantly worse sleep levels (p<0.001). We found a correlation between the number of sleeping hours (p<0.001) and the time taken to fall asleep (p<0.001) and the Beck Anxiety questionnaire Inventory with a linear worsening of the number of minutes taken to sleep as well as with the Beck Depression Inventory questionnaire. Conclusion: Among patients with inflammatory bowel disease in remission, female patients, patients with Crohn’s disease, and aged between 50 and 70 years should be considered for screening for anxiety and depression disorders and for an assessment of sleep quality.

The association of three vaccination doses with reduced gastrointestinal symptoms after severe acute respiratory syndrome coronavirus 2 infections in patients with inflammatory bowel disease

“…Vaccination against COVID-19 stimulates the immune system to produce antibodies that can neutralize the virus, thereby reducing its ability to invade and replicate within the gastrointestinal tract, consequently mitigating the severity of associated symptoms ( 36 ). Second, the COVID-19 infection might be associated with an exacerbation of anxious-depressive symptoms ( 8 ) and potentially a reduction in therapeutic adherence in IBD patients ( 9 ). Emotional fluctuations during the pandemic could be reduced by COVID vaccination, potentially reducing GI symptoms via alleviating disease activity in patients with IBD.…”

New pattern of individualized management of chronic diseases: focusing on inflammatory bowel diseases and looking to the future

“…Particular attention should be paid to the psychological factors of patients with chronic disease, which mainly based on information form patient-reported outcomes (PROs). Anxiety and depression brought by unexpected changes, epidemics ( 67 ), and sexual disorders related or not related to diseases ( 68 , 69 ) can not only directly change the intestinal flora or hormone levels of patients ( 13 ), but also affect the patient’s treatment compliance ( 67 , 70 ), thereby causing the treatment of the disease to deviate from daily routine, leading to changes in the course of the disease ( 71 ). Previous models have paid more attention to the organic lesions, dominant clinical manifestations, and genes that have already been detected in patients, while the basic life conditions and mental-psychological status closely related to each chronic disease patient have not been considered, especially at certain moments, such as sudden changes, epidemics, or unexpected accidents.…”

May ChatGPT be a tool producing medical information for common inflammatory bowel disease patients’ questions? An evidence-controlled analysis

“…The empathy physicians can create with patients with IBD is crucial to the physician-patient relationship[ 21 - 24 ]. Patients with IBD are known to suffer from a high prevalence of anxiety-depressive disorders even in remission[ 25 , 26 ]. Figure 1 summarises some general advantages and disadvantages of using ChatGPT-generated AI.…”