Hospital Anxiety and Depression Scale (HADS) in Patients of the Center of Excellence in Inflammatory Bowel Disease of the International Hospital of Colombia

Background: The Hospital Anxiety and Depression Scale HADS has been widely used to assess emotional distress in patients with different chronic conditions, it has been applied in patients who regularly attend hospital, non-psychiatric settings, thus proving to be a good tool for the detection of psychological distress in medically ill population. Among the various emotional factors related to Inflammatory Bowel Disease (IBD), anxiety and depression stand out. In Colombia, no alterations of this nature have been described in patients with IBD, so it was decided to apply this scale in the group of patients of the Center of Excellence for Inflammatory Bowel Disease of the International Hospital of Colombia (HIC). Objective: To evaluate patients with IBD who are part of the Center of Excellence for Inflammatory Bowel Disease of the HIC with a depression and anxiety scale. Materials and Methods: Descriptive observational cross-sectional study in patients diagnosed with IBD, who have been admitted to the Center of Excellence in IBD of the HIC, who were evaluated with the HADS scale, which is a self-administered questionnaire of 14 items, composed of two subscales of seven items each, one of anxiety (odd items) and the other of depression (even items) and according to these it is determined whether or not the person presents anxiety or depression (or both) and to what degree. Results: Of the 74 patients of the IBD Center of Excellence registered so far, 30% of them had the scale performed. 58% were women. In the general IBD cohort, 63.2% had no depression, 21.1% had symptoms associated with depression and 15.8% had a clinical picture of depression according to the HADS Likert scale. Considering the anxiety items, 52.6% were absent, 15.8% had symptoms associated with anxiety and 31.6% had a clinical picture of anxiety. When discriminating by type of disease, in UC there was an absence of depression in 64.3%, associated symptoms in 14.3% and a clinical picture of depression in 21.4%. As for anxiety in UC, there was an absence of anxiety in 64.3%, presence of associated symptoms in 7.1% and a clinical picture of anxiety in 29%. With respect to CD, 60% presented absence of depression and 40% presence of symptoms associated with depression, and no patient presented clinical symptoms compatible with depression. In terms of anxiety, 20% had no anxiety, 40% had symptoms associated with anxiety and 40% had clinical symptoms of anxiety. Conclusions: The data from this study demonstrate that the HADS is an easily applied and useful tool for detecting cases of anxiety and depression in the IBD population. The HADS assesses non-somatic symptoms of psychological distress; this represents a great advantage compared to other assessment measures, as these symptoms can sometimes be attributed to the disease or to the adverse effects of treatment. These results mostly agree with what has been reported in the literature regarding anxiety and depression as diagnoses that are usually interrelated in IBD, and certain tendency to a higher prevalence of anxiety with respect to depression can be observed, especially in patients with CD.