A109 BIOPSYCHOSOCIAL MODEL OF IBD: CHANGE IN PAIN PHENOTYPES AFFECTS PSYCHOLOGICAL VARIABLES

IBD is a chronic disease in which patients often experience pain. This pain may be located in sites related to the gut, or regions outside the bowel. Comorbid pain may exacerbate the impact of the disease on QoL. Our previous work demonstrated an association between psychosocial variables (e.g., depression, catastrophizing, QoL) and different pain phenotypes. The objective of this study was to evaluate the changes in pain phenotypes and how these changes related to levels of depression, catastrophizing and QoL across three time points (i.e., baseline, 6-month, and 1-year). IBD patients seen in an outpatient clinic (n = 118) completed questionnaires including body pain map, demographics, pain, depression, catastrophizing, and QoL. Patients were pain phenotyped as IBD0 if they did not endorse any pain, IBD if they endorsed pain in any area associated with IBD only (i.e., lower abdomen, pelvis and buttocks), or as IBD+ if they endorsed pain in area associated with IBD along with any other area of the body. Change in pain phenotype group from baseline to 1-year follow-up was used to categorize patients (e.g. IBD0 to IBD, IBD0 to IBD+, etc. or stable within group). Repeated measures ANOVA was conducted for depression, catastrophizing and QoL with Change Groups as between subject factors. 118 participants completed the 3 time points, 17 participants reported pain only in areas not associated with IBD and were excluded. Patients were 64.4% female (M age = 45.07 [SD = 15.26]). 68/101 participants stayed in their respective pain phenotype groups (11 IBD0, 22 IBD, 35 IBD+). 3 transferred to more severe phenotype (IBD to IBD+), 7 transferred to less severe phenotype (IBD+ to IBD), 8 who experience no pain at baseline switched to a more severe phenotype (4 IBD, 4 IBD+), and 15 transferred from any pain phenotype to a no pain phenotype (IBD or IBD+ to IBD0). There were significant differences in depression and QoL scores across Change Groups, but not for catastrophizing. Less severe phenotypes displayed lower depression scores and higher QoL scores. Participants transferring to more severe phenotypes (i.e., IBD0 to IBD, IBD to IBD+) had higher depression and lower QoL scores. Participants transferring to a less severe phenotype (i.e., IBD+ to IBD, IBD to IBD0) had lower depression and higher QoL scores. There was a significant interaction of Change Group and time for QoL; switching from IBD to IBD+ did not impact QoL, but switching from IBD+ to IBD significantly improved participants’ QoL. This study demonstrates the negative impact of pain on patient depression and QoL in IBD over time. The findings suggest that clinicians should carefully consider comorbid pain in patients with IBD as it affects how a patient copes with the disease; change to a lower pain phenotype may improve patient depression and QoL. CCC

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