The Lesson from the First Italian Lockdown: Impacts on Anxiety and Depressive Symptoms and Sleep Quality in Patients with Remission of Inflammatory Bowel Disease

Background: During the COVID-19 pandemic in Italy, decisions were taken adopting restrictive legislative measures, such as the first half of 2020 lockdown. In those months, patients with inflammatory bowel disease have experienced social isolation and reduced access to health care. Objective: Our aim was to evaluate, in this condition, the presence of remission subgroups that were most impacted by the lockdown. Methods: In the midst of the first Italian lockdown, we recruited patients with remission inflammatory bowel disease administering an online questionnaire including patient demographics, the Beck Anxiety questionnaire Inventory, the Beck Depression Inventory questionnaire and the Pittsburg Sleep Quality Index, all validated standardized questionnaires for anxiety symptom levels, depression and sleep quality. Results: Our results showed how female patients (p<0.0001) with Crohn's disease (p<0.001) experienced worse levels of anxiety symptoms. Female patients (p<0.0001), between 50 and 60 years of age (p=0.013) and with Crohn's disease (p=0.047) experienced worse levels of depressive symptoms. Females experienced significantly worse sleep levels (p<0.001). We found a correlation between the number of sleeping hours (p<0.001) and the time taken to fall asleep (p<0.001) and the Beck Anxiety questionnaire Inventory with a linear worsening of the number of minutes taken to sleep as well as with the Beck Depression Inventory questionnaire. Conclusion: Among patients with inflammatory bowel disease in remission, female patients, patients with Crohn's disease, and aged between 50 and 70 years should be considered for screening for anxiety and depression disorders and for an assessment of sleep quality.