Better disease specific patient knowledge is associated with greater anxiety in inflammatory bowel disease.
BACKGROUND
Inflammatory bowel disease (IBD)-related knowledge not only empowers patients, but may also engender anxiety. The study aimed to identify predictors of anxiety in IBD and examine the interplay between anxiety and disease-related patient knowledge. The effect of anxiety on quality of life was also explored.


METHODS
Ambulatory IBD patients provided data on demographics, their IBD and Crohn's Colitis Association (CCA) membership status. Disease-related knowledge was assessed using the validated Crohn's and Colitis Knowledge score (CCKnow) and disease related QOL using the short IBD questionnaire (SIBDQ). Anxiety and depression were assessed with the Hospital Anxiety and Depression Scores.


RESULTS
Of the 258 patients 19.4% had a potential anxiety and a further 22.4% had a probable anxiety disorder. Females (P=0.003), tertiary care patients (P=0.014) and non-Caucasian patients (P=0.037) had significantly higher anxiety levels. CCA members had marginally higher levels of anxiety (P=0.07). Anxiety was associated with significantly better patient knowledge (P=0.016) and increased depression (P<0.001). Disease related quality of life was significantly lower in patients with anxiety (P<0.001).


CONCLUSIONS
This is the first study to demonstrate that better patient knowledge is associated with higher anxiety levels. The reason for this is unclear: educating patients about their disease might trigger anxiety, but, equally, anxious patients might seek out information and hence have better knowledge. It is thus noteworthy that an educational intervention may not necessarily reduce anxiety. Further work is needed to evaluate the association between anxiety and knowledge and to develop targeted interventions that will improve knowledge and simultaneously reduce anxiety.
Gastroenterology and Liver Services, Concord Hospital and Bankstown Hospital, Sydney, Australia. Christian.selinger@web.de
Christian P
CP
Selinger
Simon
S
Lal
Jayne
J
Eaden
D Brian
DB
Jones
Peter
P
Katelaris
Grace
G
Chapman
Charles
C
McDonald
Rupert W L
RW
Leong
John
J
McLaughlin
D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology; D001315:Australia; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009939:Organizations, Nonprofit; D011788:Quality of Life; D044469:Racial Groups / Q000706:statistics & numerical data; D012737:Sex Factors; D063128:Tertiary Health Care