January 29, 2019
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IBD’s psychological factors impact quality of life of patients in remission

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Psychological distress has a clear impact on patients with active inflammatory bowel disease, but patients in remission can also be affected leading to a lower quality of life, according to research published in Inflammatory Bowel Diseases.

Gionata Fiorino, MD, PhD, of the IBD Center at the Humanitas Clinical and Research Center in Milan, Italy, and colleagues wrote that the psychological impact of IBD could be an important focus in future research.

“Although medical treatment available is efficient at controlling gastrointestinal inflammation and the symptomatic burden of IBD, the relapsing-remitting behavior of IBD can trigger psychological reactions to chronic disease,” they wrote. “Psychological factors have been suggested to play a key role in quality of life, even more than disease-related and sociodemographic factors, suggesting psychological intervention as a potential effective approach in treating IBD patients.”

Researchers enrolled 201 patients with IBD in a single-center, observational study and separated them into two groups based on disease activity (remission, n = 101; active disease, n = 100). They collected demographic and clinical data from patients, as well as validated questionnaires that evaluated for psychological distress, defense mechanisms, and quality of life.

Investigators found that the mean score for the IBD Questionnaire for quality of life wax below the cutoff level (156.8±37.8), but patients with active flares had significantly greater impairment to quality of life (136.5 vs. 177.5; P < .001). None of the patients achieved a good quality of life, even patients in remission, researchers found.

When assessing psychological scores, researchers found that no patients had a score above the cutoff for normality. However, patients with active flares had statistically higher scores for obsessive compulsive disorder (P = .026), depression (P = .013), anxiety (P = .013), phobic anxiety (P = .002), psychoticism (P = .007), global severity index (P = .005) and positive symptom total (P = .001).

Fiorino and colleagues wrote that higher levels of obsessive-compulsive disorder among patients with active disease could be related to a need to control some of the unpredictable symptoms of the disease. Additionally, anxiety could potentially be linked to the fear of being forced into uncomfortable social situations by their disease.

“Further data are needed to demonstrate that psychological intervention may play a key role in the therapeutic strategies used for IBD patients and to identify specific psychological patterns in IBD patients that may help in tailoring the psychological intervention according to the patient’s profile,” the authors wrote. – by Alex Young

Disclosures: Healio Gastroenterology and Liver Disease could not confirm the authors’ relevant financial disclosures prior to publication.