Illness Identity and the Relationship With Participation and Quality of Life Among Adolescents With Celiac Disease

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Celiac disease is a chronic condition, treated by a strict lifelong gluten-free diet. Adolescents need to gain independence and assume responsibility for self-managing their diet while participating in daily food-related activities. Maintaining health, well-being, and quality of life and developing self- and illness identity are central developmental tasks during adolescence. OTs have an important role in addressing and promoting health management needs. Primary Author and Speaker: Sonya Meyer Additional Authors and Speakers: Liron Lamash

P495 The interplay of biopsychosocial factors and quality of life in Inflammatory Bowel Diseases: a network analysis

Background Quality of life (QoL) is one of the most relevant patient-reported outcomes in the treatment of patients with inflammatory bowel diseases (IBD), but does not only depend on disease activity. We aimed to investigate the interplay of biopsychosocial factors and their associations with QoL in patients IBD by using a network analytical approach (NA). Methods We measured QoL and anxiety, depression, illness identity, self-esteem, loneliness, childhood trauma, and visceral sensitivity with self-report questionnaires in two independent IBD-samples (sample 1: n=209, anonymous internet survey; sample 2: n=84, outpatients with active disease before the beginning of a biologic treatment). Additionally, fatigue, haemoglobin levels and response to biologic therapy (3–6 months after the first assessment) were assessed in sample 2. We estimated regularized partial correlation networks and conducted tests of accuracy and stability of the network parameters. Results In both samples, QoL had the strongest associations with visceral sensitivity and the illness identity dimension engulfment, a maladaptive integration of IBD into the ‘self’. QoL was uniquely associated with depressive symptoms and fatigue was an essential factor in this link (sample 2). Depression was the most central factor in the networks. Baseline depression scores were connected to response to biologic therapy in sample 2. Conclusion This is the first study using NA to assess the complex interplay between biopsychosocial factors and QoL in IBD. It reveals a comparable network structure in two independent samples emphasizing the importance of depression. Visceral sensitivity and engulfment connected most strongly to QoL. Beyond depression, visceral sensitivity and illness identity may be targetable characteristics to improve QoL in personalised holistic therapy in IBD.