PREVALENCE AND IMPACTS OF POST-TRAUMATIC STRESS SYMPTOMS IN IBD PATIENTS FROM UNDER-REPRESENTED MINORY GROUPS

Abstract

DISCUSSION: Social media analysis reveals a dynamic range of themes governing patients' perspectives and experiences with CPF. The use of a mixed-methods approach generated complementary insights regarding patients' need for information about CPF, the biopsychosocial burden of CPF, the different encountered challenges with treatment and the difficulty to navigate among available management options. These results highlight a gap in patient educational needs for CPF. BACKGROUND: Poor sleep occurs in 75% of people with IBD and is prospectively associated with increased risk for disease flare, hospitalization, surgery, and reduced quality of life. While IBD providers know the link between poor sleep and IBD, few are adequately armed to ask patients about sleep and provide concise, evidence based suggestions for management. We aimed to understand patients' beliefs about sleep and IBD, their treatment preferences, and offer recommendations to providers on how best to ask about and address sleep problems in this population. METHOD: We conducted an anonymous, online survey of 312 adults with Crohn's disease or ulcerative colitis who sought treatment at the Dartmouth-Hitchcock IBD center. Participants were asked about sleep patterns, thoughts and behaviors related to sleep, and open-ended questions about sleep and IBD. RESULTS: Participants ranged from 18-85 years old (M¼48.6, SD¼16.1) and were 66% women, 96% White. 61% of participants had Crohn's and 39% had UC; mean symptom duration¼20.7 years (SD¼13.7). Overall, 81% of participants endorsed some interaction between sleep and IBD. Based on thematic analysis, participants thought that their sleep was worse during flares and sleeping poorly made IBD symptoms worse, while good sleep was protective. Pain, nighttime bowel movements, and general and IBD-specific anxiety all worsened sleep. Participants with poor sleep evidenced more dysfunctional beliefs about sleep (d¼1.68, p 4 ¼ active IBD, NIH-PROMIS QoL module (fatigue, sleep disturbance, social isolation, pain interreference), and PTSD Checklist-5 (PCL5) with >30 ¼ suggested IBD-PTS, with subscale scores. Independent samples t-Test, Pearson's correlation, and hierarchical linear regression statistics were used. RESULTS: 67 participants: 46% UC, 79% female, 73% South/ Southeast Asian, 6% Hispanic, Age (MeanAESD) ¼ 35.42AE9.79 years. 55% had active IBD (HBI/SCCAI > 4;