IDDF2018-ABS-0250 Determinants of depression and its impact on quality of life in patients with chronic pancreatitis

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Abstract

Background

We evaluated the prevalence of depression and its impact on quality of life(QOL) in CP.

Methods

Consecutive patients with CP were screened from Aug-17’-Jan-18’. Following were recorded: demography (age/gender/education/socioeconomic status); past 3mths pain details (episodes/intensity[VAS]/severity[mild/moderate/severe]/nature[intermittent/continuous]); other parameters (aetiology/duration/diabetes/weight loss/morphology[pancreatic duct size/calculi/calcifications]; and treatment details (diet/medical/interventional/compliance).

Methods

Depression was measured using Beck’s Depression Inventory (BDI); QOL using QORTC-QLQ30 +PAN28 tool.

Methods

ANOVA/Kruskal-Wallis, chi-square test and Pearson coefficient were used as appropriate. Logistic regression was used to identify independent associations with depression. Principal component analysis (PCA) with biplot and hierarchical cluster analysis (Euclidean distance) were done to evaluate the relationship of depression categories with QOL.

Methods

A Bonferroni corrected two-tailed ‘p’ value of <0.025 was considered statistically significant.

Results

224 patients were screened of which 208 were included. 151 (72.6%) were males, and the most common aetiology was –idiopathic (150 [72.1%]). Depression was seen in 125 (60.1%) patients (figure 1a). Frequencies of depression categories are depicted in IDDF2018-ABS-0250 figure 1b. There was a significant positive correlation between depression score with a number of pain episodes (r=0.464; p=0.02). Socio-economic status and continuous pain were independently associated with depression (p<0.0001 and 0.02 respectively).

Results

PCA demonstrated clustering of patients with and without depression. Biplot vectors showed the strongest negative correlation of the depression grades with global health (p<0.0001), role function (p=0.013), physical function (p=0.009), emotional function (p=0.004) and cognitive function (p=0.017), while strongest positive correlation with fatigue (p=0.001) and insomnia (p=0.004) in the QORTC QLQ-30 (figure 2a). Clustering of the different categories of depression in the context of QOL domains was confirmed by the hierarchical clustering (Cophen. coeff. 0.719) (figure 2b).

Conclusions

Continuous pain and socioeconomic status independently determine the development of depression in CP. Depression adversely impacts the global, functional, emotional and cognitive components of the QOL.

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