P0592 - Prevalence of Depression and Anxiety Among Elderly Veterans With Inflammatory Bowel Disease During the COVID-19 Pandemic

Kenneth Leung, MD¹, Yinglin Gao, DO², Muhammad B. Hammami, MD^3
1University of California Riverside School of Medicine, San Bernardino, CA; ²Loma Linda University Medical Center, Loma Linda, CA; ³VA Loma Linda Healthcare System, Rancho Cucamonga, CA

Introduction: Anxiety and depression are common and often underdiagnosed in patients with inflammatory bowel disease (IBD). The coronavirus disease 2019 (COVID19) pandemic and advanced age have been associated with mental health challenges. The prevalence of anxiety and depression among elderly IBD patients during COVID19 is not well described.

Methods: Veterans ≥60 years old who were evaluated at the Loma Linda Veteran Affairs Healthcare System IBD clinic between 7-2020 to 4-2021 were referred for phone assessment with a Licensed Clinical Social Worker (LCSW). The LCSW completed Patient Health Questionnaire-9 (PHQ9) and General Anxiety Disorder-7 (GAD7). PHQ9 depression severity scores of 5, 10, 15, and 20 were considered cut-points for mild, moderate, moderately-severe, and severe depression, respectively. GAD7 anxiety severity scores of 5, 10, and 15 were considered cut-points for mild, moderate, and severe anxiety, respectively. The results were compared with the related report of the Centers for Disease Control and Prevention (CDC) on general US population (6/24-30/2020) using PHQ2 and GAD2.

Results: A total of 94 consecutive veterans met referral criteria. Their demographics and IBD characteristics are outlined in Table 1. Fifty-eight (62%) patients completed the evaluation. Of the 58 patients, 19 (33%), 2 (3%), and 1 (2%) had mild or moderate, moderately-severe, and severe depression, respectively, including 2 (3%) patients with suicidal ideations. Further, 12 (21%), 3 (5%), and 2 (3%) had mild, moderate, and severe anxiety, respectively. Eight patients were provided social resources, including mental health, psychotherapy, and meals on wheels, and 4 had follow-up visits with the LCSW. Restricting the analysis to patients ≥65 years old and using the CDC diagnostic criteria, the prevalence of depression and anxiety in the current study was 12.8% and 19.1%, compared to 5.8% and 6.2% in the general US population.



Discussion: The high prevalence of depression and anxiety despite the majority of patients being in clinical remission may be explained by the overall IBD morbidity that may have been worsened by physical distancing and stay-at-home orders. The study suggests that the majority of veterans may be receptive to speaking with a LCSW about depression and anxiety and to receiving further intervention. Our results support routine screening of elderly IBD patients for depression and anxiety disorders and that PHQ9/GAD7 may be more sensitive than simplified PHQ2/GAD2.



Disclosures:


Kenneth Leung, MD¹, Yinglin Gao, DO², Muhammad B. Hammami, MD³. P0592 - Prevalence of Depression and Anxiety Among Elderly Veterans With Inflammatory Bowel Disease During the COVID-19 Pandemic, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.