Relevance of Major Stress Events as an Indicator of Disease Activity Prevalence in Inflammatory Bowel Disease

The impact of psychological stress in recurrence of inflammatory bowel disease (IBD) is unclear. Why some patients with ulcerative colitis (UC) or Crohn's disease (CD) have unrelenting relapses whereas other IBD patients experience long periods of quiescent disease remains an enigma. The author...

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Published in:Behavioral medicine (Washington, D.C.) D.C.), 1991-09, Vol.17 (3), p.101-110
Main Authors: Duffy, Linda C., Zielezny, Maria A., Marshall, James R., Byers, Tim E., Weiser, Milton M., Phillips, James F., Calkins, Beverly M., Ogra, Pearay L., Graham, Saxon
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
clinical disease activity index
Colitis, Ulcerative - psychology
Crohn Disease - psychology
Crohn's disease
Female
Follow-Up Studies
Gastroenterology. Liver. Pancreas. Abdomen
Humans
inflammatory bowe1 disease
Life Change Events
major stress events
Male
Medical sciences
Other diseases. Semiology
Personality Inventory
Prospective Studies
Psychophysiologic Disorders - psychology
Risk Factors
Sick Role
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
ulcerative colitis
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Summary:The impact of psychological stress in recurrence of inflammatory bowel disease (IBD) is unclear. Why some patients with ulcerative colitis (UC) or Crohn's disease (CD) have unrelenting relapses whereas other IBD patients experience long periods of quiescent disease remains an enigma. The authors examined the risk of exposure to major stress events in clinical episodes of IBD. They followed up on 124 persons in a prospective study that monitored behavioral and biological characteristics for a period of 6 months. Stress-exposed subjects demonstrated increased risk of clinical episodes of disease when compared with unexposed subjects (RR = 2.6, 95% CI: 1.3-4.9). Elevated effect measures were highest for the domain of health-related stress (RR = 3.8, 95% CI: 1.5-9.9). In the multiple regression analysis, major stress events remained the most significant indicator of disease activity in the presence of the covariables considered. Only 7% of the variation in disease activity was uniquely attributed to stress. Baseline activity was the other notable indicator of subsequent disease activity in the study sample. All variables considered together explained 52% of the variance observed and implicated factors of potential clinical importance in monitoring recurrence of the disease.
ISSN:0896-4289
1940-4026
DOI:10.1080/08964289.1991.9937553