Mo1831 CAUSES AND CONSEQUENCES OF AFFECTIVE SPECTRUM DISORDERS IN INFLAMMATORY BOWEL DISEASE Matthew Coates, Jayakrishna Chintanaboina, Seyedehsan Navabi, Venkata Subhash Gorrepati, Sarah Maher, Peter Demuth, Benjamin Stern, Walter Koltun, Sue Deiling, August Stuart, Andrew Tinsley, Kofi Clarke, Emmanuelle D. Williams BACKGROUND: Individuals with inflammatory bowel disease (IBD) are more likely to develop affective spectrum disorders (ASD) when compared to age-matched healthy counter- parts. Crohn's disease (CD) and ulcerative colitis (UC) are often more challenging in the setting of ASD and is often associated with poor quality of life and increased healthcare costs. IBD providers need to better understand the causes of these disorders in order to improve care for IBD patients and to limit the enhanced financial burden associated with coincident ASD. The aim of this study was to identify clinical factors that influence develop- ment of ASD in IBD. METHODS: This is a retrospective analysis using a data from a IBD natural history registry from a single tertiary care referral center between 1/1/15-8/31/16. Presence of anxiety or depression was determined based upon responses to the Hospital Anxiety and Depression Scale (score of 8 or more indicated the clinically significant presence of each). Age, gender, IBD duration, IBD extent, disease complications (ex: abscess, stricture), extra-intestinal manifestations of IBD (EIM), endoscopic severity, Harvey Bradshaw Index, Simple Clinical Colitis Activity Index, medications, surgeries, laboratory values (ESR, CRP, Vitamin D, B12, Zinc), opiate and tobacco use were also abstracted. RESULTS: A total of 432 IBD patients (228f:204m) were included in this study. 132 had UC (30.6%), 256 had CD (59.3%) and 44 had indeterminate colitis (10.2%). 192 IBD patients (44.4%) were found to have ASD and most of these were female (59.4%, p<0.05). IBD patients with ASD were much more likely to use corticosteroids (52.4% vs. 38.5%, p<0.01), biologics (49.3% vs. 38.1%, p<0.05), opiates (26.0%vs.13.3%, p<0.001) and/or smoke (18.2%vs.7.9%, p<0.01). Presence of moderate-severe disease activity (59.4% vs. 39.6%, p<0.001) and EIM (42.7%vs.29.2%, p<0.01) were more common in patients with ASD. They also had higher mean ESR (p<0.05) and WBC (p<0.01) values. Additionally, ASD was associated with a lower mean vitamin B12 level and all of the patients with deficient B12 levels met criteria for ASD. Using multivariate analysis, moderate-severe disease (p<0.05), female gender (p<0.001), smoking (p<0.01) and presence of EIM (p<0.05) were each independently predictive of ASD. Similar trends were observed in both the UC and CD subpopulations. SUMMARY AND CONCLUSIONS: Anxiety and depression are common in the setting of IBD and strongly associated with increased disease activity, heavier disease burden (including presence of EIM), smoking and female gender. Other factors, including lower vitamin B12 levels, also may play a role, though further investigation is necessary to confirm this. This study helps to further refine our understanding of ASD development in IBD and provides additional strategies for risk identification and management in this setting. Mo1832 FEMALE GENDER, SOMATIZATION AND PRESENCE OF IBS-TYPE SYMPTOMS PREDICTS DYSPAREUNIA IN PATIENTS WITH IBD Anthony O'Connor, David J. Gracie, Christian Selinger, John Hamlin, Alexander C. Ford Background Sexual dysfunction is a well-recognized complication of chronic illness. In IBD factors such as age of diagnosis, increased bowel frequency, abdominal pain, fatigue, incontinence, perianal fistulas, abscesses, or skin tags, can lead to an accumulation of physical and psychosocial factors that can impair sexual function. Although 80% of IBD patients report sexual dysfunction only 40% will discuss it with their healthcare provider. Dyspareunia has been reported as occuring in unto 40% of patients with IBD. Methods We analyzed Rome III IBS symptoms, disease activity indices, and psychological, somatization, and quality of life data from 777 consecutive, unselected adult patients with IBD seen in clinics at St James's University Hospital in Leeds, United Kingdom from November 2012 through June 2015. Participants also provided a stool sample for fecal calprotectin (FC) analysis and serum for CRP. Results The overall prevalence of dyspareunia in our IBD cohort was 11.2%. 5.5% of males reported dyspareunia (19/348) compared to 18.2% of females (78/429) (p<0.0001). 64.4% (55/87) of patients reporting dyspareunia were married compared to 60.4% (417/ 690) of patients without dyspareunia. The median age of patients with dyspareunia was 37 years compared to 42 years without. Median BMI was 25.58 in the group with dyspareunia and 24.53 in the group without. 11.5% of patients with Crohn's disease (51/444) reported dyspareunia compared to 10.8% of UC patients (36/333) (P=0.8186). Prevalence of prior surgery was 25.3% (22/87) in the dyspareunia group compared to 25.8% of those without (178/690). Prevalence of perianal disease was 3.5% (3/87) in the dyspareunia group compared to 4.2% of those without (29/690). Median FC was 174.6 in the dyspareunia group compared to 150.1 of those without. CRP was elevated in 35.6% (31/87) of patients with dyspareunia group compared to 39.4% of those without (272/690). 54.0% (47/87) of patients with dyspareunia reported the presence of IBS-type symptoms compared to 34.8% (240/690) of those without (p=0.0006). Median Somatic Symptom Scale - 8 (SSS-8) was 15 in the dyspareunia group compared to 9 in those without. Patient Health Questionnaire-12 (phq12) somatisation score was 11 in the dyspareunia group compared to 6 in those without. Conclusions The prevalence of dyspareunia in our centre is lower than some of the previously reported iBD cohorts. Dyspareunia was associated with IBS-type symptoms, female gender and higher somatisation scores but not with disease phenotype or other demographic factors. S-795 AGA Abstracts Mo1833 HEALTH MAINTENANCE DIFFERENCES IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE BETWEEN GENERAL GASTROENTEROLOGY CLINICS AND SPECIALIST Mir Fahad Faisal, Raj Shah, Mahathi Indaram, Cody Braun, Talal Asif, Fadi Hamid, Wendell K. Clarkston Introduction: Patients with inflammatory bowel disease (IBD) have adult health maintenance (AHM) needs in addition to those for age-matched non IBD patients. Yet there is evidence that IBD patients meet AHM standards less often then general population. Screening recom- mendations for skin, cervical and colon cancer differ and additional vaccines, bone health, depression screening and smoking counseling is recommended. We assessed quality of health maintenance in IBD patients in the general gastroenterology (GI) clinic and compare them to an IBD expert. Methods: We reviewed charts of patients at our center between 2014-2016 seen for management for IBD in the outpatient GI clinics. Patients were categorized as either managed by an IBD Specialist (Physician A) and those seen by other non-IBD Specialists (Physicians B). AHM needs of each patient were evaluated which included vaccina- tion status, DEXA scanning, tobacco use, tuberculosis testing before biologic agents and screening for depression, colon cancer and skin cancer. Patients on maintenance therapy were assessed for adequate monitoring (CBC and BMP as recommended per treatment regimen). Chi square was used for analysis. Results: 135 patients met inclusion criteria, 36 were seen by physician A and 99 by physicians B. Significantly higher number of patients seen by Physician A (76%) received or were recommended Calcium and Vitamin D supple- mentation vs. physician B (22%) p< 0.001. Screening for depression by physician A (67%) was significantly higher vs. physicians B (40%) p= 0.007. Sunscreen was recommended significantly more frequently in physician A (58%) vs. Physicians B (20%). Disease was staged using the Montreal classification significantly more frequently by physician A (p<0.001). In patients who were on immunomodulator therapy, 71% patients seen by physician A received TPMT testing prior to initiation of treatment vs. 25% patients who were seen by physicians B, p = 0.011. On immunomodulator therapy, significantly higher number of patients seen by physician A (100%) received follow-up lab investigations vs. those seen by physicians B (75%) p = 0.044. 50% of African Americans who had Ulcerative colitis were cigarette smokers vs. 25% of Caucasians. 50% of African Americans with Crohn's Disease were cigarette smokers vs. 37% of Caucasians. Smoking cessation counseling was equal among both physician groups. Conclusion: Patients with IBD benefit from assessment by an IBD specialist at least once. Significantly higher proportion of patients assessed by an IBD specialist had screening for depression, bone health, sunscreen counseling, disease staging with Mon- treal classification, TMPT levels prior to initiation of Immunomodulator therapy and routine follow-up lab investigations while on immunomodulators. Mo1834 PSYCHO-SOCIAL PREDICTORS OF NONCOMPLIANCE WITH CHRONIC DRUG TREATMENT IN CROHN'S DISEASE AND ULCERATIVE COLITIS Doron Schwartz, Batel Lasry, Moataz Abo Abod, Dan Greenberg, Michael Friger, Elena Chernin, Hillel Vardi, Orly Sarid, Vered Slonim-Nevo, Selwyn H. Odes Background & Aims: Crohn's disease (CD) and Ulcerative Colitis (UC) are chronic diseases requiring maintenance therapy to prevent relapse and further complications. Compliance with treatment is associated with improved outcomes. We aimed to identify psycho-social factors associated with noncompliance to chronic drug treatment. Methods: From the electronic adult patient database of the gastroenterology department of a large tertiary care hospital we identified 128 CD and 101 UC patients receiving maintenance treatment for one year (6 months before and 6 months after study enrollment). These patients were contacted and filled in their demographics, economic status, disease activity (Harvey Brad- shaw Index (P-HBI) for CD, Simple Clinical Colitis Activity Index (SCCAI) for UC), Brief Symptom Inventory (psychological stress score, GSI), Brief COPE Inventory (coping strate- gies), SF-36 (quality-of-life Physical Health (PH) and Mental Health (MH) scores), and SIBDQ. For each patient, drug refill information for the study period was obtained from computerized pharmacy records. Compliance was defined as at least 80% acquisition of prescribed medication. Univariate analysis and regression models were used to identify significant associations for compliance. Nonparametric data are medians (IQR). Results: There were 78 (61% of total) CD and 59 (53.15%) UC noncompliant patients. Age, gender, education, disease duration and coping strategies were not related to compliance. CD non- compliant patients as compared with UC were more likely to be unemployed (CD 47.4% vs. UC 28.6%, p=0.035), had "poor" economic status (30.3% vs. 8.5%, p=0.004), had active disease (54.2% vs. 27.9%, p=0.006), lower SIBDQ score (44 (IQR 9—68) vs. 53 (20—70), p=0.004), higher GSI (0.42 (0—2.39) vs. 0.23 (0—1.68), p=0.009), and lower SF-36 Physical Health (44.1 (14.1—65.9) vs. 46.7 (25.7—60.1), p=0.03). UC noncompliance was associated with non-smoking (UC 98.3% vs. CD 85.7%, p=-.013). Quantile regression models (Figures) revealed further differences between CD and UC patients. Conclusion: Psycho-social predic- tors of noncompliance were different in CD and UC patients. While CD compliance was associated with unemployment, poverty, psychological stress and less physical health, UC noncompliance was only associated with non-smoking. Quantile regression analysis AGA Abstracts