COVID-19 Pandemic's Effects on Disease and Psychological Outcomes of People with Inflammatory Bowel Disease in Portugal: A Preliminary Research

Abstract

Aims: No empirical research on the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on people living with IBD, a population known to typically present high levels of anxiety and depression and to be potentially vulnerable to COVID-19, has yet been conducted. This study aimed to explore the links between contextual variables related to the COVID-19 pandemic and disease and psychological outcomes. Methods: The sample included 124 Portuguese patients with Crohn's disease or ulcerative colitis (85.48% women) who completed self-reported measures in an online survey during April 2020. Results: Fear of contracting COVID-19 and medication adherence were both high and unrelated. About half of the sample presented moderate (37.10%) to severe (14.50%) anxiety. Normal and mild anxiety levels were at 29.80% and 18.50%, respectively. Regarding depressive symptoms, 51.60% of the sample presented normal levels, 27.40% mild severity, 16.10% moderate, and 4.8% severe. No differences were found between Crohn's disease and ulcerative colitis patients. Regression analyses showed that anxiety explained IBD symptom perception (β = 0.29; P = 0.022); fear of contracting COVID-19 (β = 0.35; P < 0.001) and IBD symptom perception (β = -0.22; P = 0.009) explained depressive symptoms; and fear of contracting COVID-19 (β = 0.41; P < 0.001), IBD symptom perception (β = 0.26, P < 0.001), and being in isolation (β = -0.16, P = 0.041) explained anxiety. Type of medication was not linked to these outcomes. Conclusions: The COVID-19 pandemic does not seem to be affecting adherence to medication but seems to present relevant effects on psychological well-being. Inflammatory bowel disease health care professionals should be attentive of patients' psychological response to this pandemic and of its possible consequences on disease expression. This study additionally provided a psychometrically sound measure of fear of contracting COVID-19.