Anxiety and depression in colorectal Pelvic Floor Disorders among low Socioeconomic Status and ethnic groups

Rationale:

While anxiety and depression are noted in Pelvic Floor Disorders (PFD) patients, their influence on care and association with Socioeconomic Status (SES) and ethnicity are unstudied.

Objective:

To assess the impact of psychiatric conditions on PFD among ethnic minorities and different SES.

Methods:

A retrospective study conducted at Guy’s and St Thomas’ Hospital, London, UK. Patient demographics, main complaints, symptoms, psychiatric disorders, and data related to the entire care process were collected.

To assess the patients’ SES, we used the Index of Multiple Deprivation scores and grouped them into quintiles, with the lowest quintile representing the most deprived. Statistical tests evaluated how the care process differed between patients with and without psychiatric disorders, anxiety, or depression.

Findings:

Out of 2001 patients, 399 had at least one psychiatric disorder. These patients had higher rates of fecal​ incontinence (p = 0.02) and missed follow-up appointments more often (p = 0.005). No significant differences in clinical variables were found between patients with and without anxiety. Patients with depression had higher rates of anal incontinence (p = 0.005) and higher rates of referrals from the Telephone Assessment Triage Clinic to tests, diagnostic tests, and discussions in multidisciplinary meetings (p = 0.03, p = 0.04, p = 0.04). Furthermore, they were less likely to complete the care cycle (p = 0.02).

Conclusions:

This study highlights the impact of depression on patient care, underscoring the need to prioritize mental health for optimal treatment. No significant associations were found between psychiatric disorders and SES or ethnicity. Larger future studies are needed to explore potential correlations and develop targeted emotional support strategies.