Differing Relationship of Psycho-Social Variables with Active Ulcerative Colitis or Crohn's Disease

Orly Sarid; Vered Slonim-Nevo; Doron Schwartz; Michael Friger; Ruslan Sergienko; Avihu Pereg; Hillel Vardi; Elena Chernin; Terri Singer; Dan Greenberg; Shmuel Odes; Israel IBD Research Nucleus (IIRN)

doi:10.1007/s12529-018-9712-5

Differing Relationship of Psycho-Social Variables with Active Ulcerative Colitis or Crohn's Disease

Int J Behav Med. 2018 Jun;25(3):341-350. doi: 10.1007/s12529-018-9712-5.

Affiliations

¹ Spitzer Department of Social Work, Ben-Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel.
² Department of Gastroenterology and Hepatology, Soroka Medical Center, Rager Blvd, 84101, Beer Sheva, Israel.
³ Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel.
⁴ Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel.
⁵ Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, 84105, Beer-Sheva, Israel.
⁶ Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel. odes@bgu.ac.il.

PMID: 29524119
DOI: 10.1007/s12529-018-9712-5

Abstract

Purpose: How psycho-social variables affect the degree of disease activity in patients with ulcerative colitis (UC) or Crohn's disease (CD) is incompletely understood. Therefore, we measured and compared the impact of psycho-social variables on the active disease state in UC and CD.

Method: One hundred and twenty-two UC and 305 CD patients with active disease completed questionnaires detailing their psychological symptoms, threatening experiences, disease-coping strategies, satisfaction with life, quality of life, and demographics.

Results: UC and CD patients were aged (mean, SD) 38.6 ± 14.0 and 45.2 ± 15.1 years, respectively. The psychological symptom index (median, IQR) was greater in UC 1.24 (0.8) than CD 0.9 (0.8), p < 0.001. UC used more emotion-focused strategies, 24.5 (5.7) than CD, 23.0 (5.7), p < 0.03; problem-focused strategies, 16.4 (4.5) vs. 15.4 (4.2), p < 0.04; and dysfunctional strategies, 23.7 (5.7) vs. 22.0 (5.0), p < 0.01. UC activity correlated with gender, age, economic status, psychological symptoms, threatening experiences, all coping strategies, satisfaction with life, and quality of life (p < 0.02-0.001). CD activity correlated with economic status, psychological symptoms, threatening experiences, dysfunctional strategies, satisfaction with life, and quality of life (p < 0.05-0.001). UC activity was predicted by psychological symptoms (9.1% variance), economic status (6.9%), problem-focused strategies (4.2%), and threatening experiences (1.3%); CD activity by threatening experiences (5% variance) and psychological symptoms (4%). In path analysis, psychological symptoms and problem-focused strategies mediated the effects of economic status, age, and threatening experiences on UC activity. In CD, the dominant pathway was threatening experiences impacting on psychological symptoms.

Conclusion: The impact of psycho-social variables on the active disease state differs between UC and CD, thus indicating a need for specifically tailored psychotherapies.

Keywords: Crohn’s disease; Disease-coping strategies; Psychological distress; Structural equation modeling; Ulcerative colitis.

MeSH terms

Adaptation, Psychological*
Adult
Colitis, Ulcerative / psychology*
Crohn Disease / psychology*
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Personal Satisfaction
Quality of Life*
Socioeconomic Factors
Surveys and Questionnaires
Young Adult

Grants and funding

2012PG-IBD006/The Leona M. and Harry B. Helmsley Charitable Trust