The Association Between Increased Maladaptive Health Behaviours and Elevated Mental Health Symptoms Among Persons with IBD During the COVID-19 Pandemic

AIM: To assess the association between maladaptive health behaviours and elevated mental health (MH) symptoms during the COVID-19 pandemic among persons with inflammatory bowel disease (IBD). METHODS: Participants of the population-based University of Manitoba IBD Research Registry (n = 2,942) were invited to participate in a survey in November 2020, regarding their experiences during the COVID-19 pandemic. Maladaptive health behaviours included increased use of alcohol, marijuana, and cigarettes, and reduced exercise relative to pre-pandemic levels. Clinically significant MH symptoms were defined by the presence of elevated anxiety, depression, and/or post-traumatic stress. Adjusted logistic regression assessed the odds of elevated MH symptoms predicted by maladaptive health behaviours, stratified by gender. RESULTS: Of 1,363 (46%) respondents, 319 (23%) had elevated MH symptoms. Those with elevated MH symptoms were older (mean age 54) and predominantly females (70%). The odds of any elevated MH symptoms were approximately two to four times greater among those who experienced maladaptive health behaviours during the pandemic including: increased alcohol use [aOR 2.14, 95% CI (1.50–3.05)], males who increased marijuana use [aOR 4.18, 95% CI (1.18–14.74)], females who increased smoking cigarettes [aOR 3.68 95% CI (1.15–11.86)] and any maladaptive health behaviour [aOR 1.93 95% CI (1.44–2.60)]. CONCLUSION: During the COVID-19 pandemic, persons with IBD who experienced any maladaptive health behaviour was associated with double the likelihood of experiencing clinically significant MH symptoms. For persons with elevated MH symptoms, it is important for health care providers to recognize the association of increased maladaptive behaviours. Alternatively, if it is determined that MH symptoms predated maladaptive health behaviours then, inquiries into MH and providing appropriate referrals should be pursued.