People living with IBD already have high rates of anxiety and depression and this has been worsened during the COVID-19 pandemic due to fears of infection and the restrictions of social distancing.

Mental health findings from a survey of more than 350 Australian adults living with IBD have led to calls for wider access to IBD nurses and for reassurance to be provided from treating clinicians about infection risks for patients.

The national online survey carried out between June and July 2020 by researchers based at Blacktown Hospital NSW, found that 61% of people with IBD met the criteria for at least moderate depression, anxiety or stress, and almost half (45%) had a diagnosis of depression and/or anxiety.

It’s already known that around 10-20% of people with IBD may have depression and more than a third  have anxiety, but the survey showed that over two thirds of the people with IBD reported worsening of their pre-existing depression/anxiety due to the current pandemic.

High rates of moderate to severe depression (35%), anxiety (32%) and stress (30%) were also seen in those without a pre-existing diagnosis of anxiety or depression.

People were more prone to anxiety and depression if they were younger, had active symptomatic disease and perceived they faced an increased susceptibility to COVID-19 infection compared to the general population.

Other factors associated with anxiety and depression were lack of access to an IBD nurse and lack of advice from medical practitioner regarding reducing COVID-19 infection

Writing in BMJ Open Gastro, the study investigators said it was notable that many people with IBD had fears about a possible increased risk of COVID-19 infection, even though a recent meta-analysis of studies found a lower incidence of COVID-19 infection among IBD populations, when compared with incidence reported in general population.

However while patients with IBD are not generally more susceptible to COVID-19 than others, some studies have suggested that active disease and glucocorticoids may be risk factors for severe COVID-19 infection, they noted.

The authors concluded that their findings had showed that pandemic fears had exacerbated the already high rates of pre-existing mental health problems  among people with IBD – and also triggered anxiety and depression among those without prior psychological problems.

“Access to an IBD nurse and advice from medical practitioner on reducing infection risk were two modifiable factors that may protect against significant depression, anxiety and stress,” they said

“Investing healthcare resources to improve access to IBD nurses and ensure patients can readily access their treating doctor during the COVID-19 pandemic may, therefore, have a positive impact on the mental health of patients with IBD, among the other obvious benefits.”