DOP070 Development and pilot of an index to identify young people with inflammatory bowel disease at risk of psychological morbidity

Abstract

Background: Young People (YP) living with inflammatory bowel disease (IBD) are at an increased risk of psychological morbidity. There is growing interest in risk factor stratification in psychological screening as a means of implementing the European Crohn's and Colitis Organisation psychological screening recommendations. This study aimed to develop a novel index to predict future anxiety and depression: IBD Risk Assessment PsychologicalmorbIDity (IBDRAPID) for use in 16-24 year olds. Methods: An initial 30-item version, IBD-RAPID-30, was developed from evidence obtained in: (1) systematic review of psychological morbidity risk factors in YP with IBD; (2) original research into the illness perceptions of YP with IBD; (3) risk factors for psychological morbidity in YP with other chronic diseases. Following expert review of IBD-RAPID-30 through focus groups, a revised 35-item version was developed: IBD-RAPID-35. YP aged 16-24 years with a confirmed diagnosis of IBD were then recruited for a pilot study from the following; (1) local paediatric and adult IBD centres; (2) existing research database of YP with IBD (3) web-based recruitment advertised through Twitter and several IBD charitable organisations. Participants completed IBD-RAPID-35, Hospital Anxiety and Depression Scale (HADS), Inflammatory Bowel Disease Questionnaire (IBDQ), an adapted acceptability questionnaire and recorded their future disclosure preferences. Results: Sixty-five participants were recruited. Participants had a median age of 22 years (16-24) with 38 females (58%). 36 had a diagnosis of Crohn's disease (55%), 21 ulcerative colitis (32%), 8 unknown (12%). Sixty-two (97%) participants were willing to repeat the survey at future time points, with 94% finding it either “easy” or “very easy” to complete. The emotional representations of IBD items were most strongly associated with anxiety (r = 0.687, p < 0.0001) and depression (r = 0.580, p < 0.0001) scores. Items related to general well-being (r = 0.567), hopelessness (r = 0.515), and availability of someone to confide in (r = 0.504) were significantly associated with depression sub-scale scores (all p < 0.0001). Participants were most willing to allow an IBD nurse specialist (89%) or IBD consultant (87%) to view their IBD-RAPID-35 responses, with general practitioner the least frequent named response (55%). Conclusions: IBD-RAPID-35 is highly acceptable for use in 16-24 year olds with IBD. A longitudinal study is feasible, which would allow the identification of items with the strongest predictive ability, with the intention of developing a shortened, clinically acceptable risk index. Further studies are needed to assess the benefit of early identification and subsequent intervention in this population.