Psychological distress, social support, and disease activity in patients with inflammatory bowel disease

• Published in: The American journal of gastroenterology Vol. 96; no. 5; pp. 1470 - 1479
• Main Authors: Sewitch, Maida J., Abrahamowicz, Michal, Bitton, Alain, Daly, Donald, Wild, Gary E., Cohen, Albert, Katz, Saul, Szego, Peter L., Dobkin, Patricia L.
• Format: Journal Article
• Language: English
• Published: Oxford . 01-05-2001; Blackwell Publishing; Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cross-Sectional Studies; Female; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Inflammatory bowel disease; Inflammatory Bowel Diseases - physiopathology; Inflammatory Bowel Diseases - psychology; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Psychology; Social Support; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Stress, Psychological - etiology; Human; Distress behavior; Crohn disease; Improvement; Digestive diseases; Intestinal disease; Epidemiology; Inflammatory disease; Psychological well being; Quality of life; Ulcerative colitis; Social support
• ISSN: 0002-9270; 1572-0241
• DOI: 10.1111/j.1572-0241.2001.03800.x

The objectives of this study were to compare the psychological status of patients in active and inactive disease states, to assess social support, and to identify correlates of psychological distress in patients with inflammatory bowel disease (IBD). This cross-sectional study was conducted in 200 patients (mean age 36.7 yr [SD = 14.8], 119 [59.5%] female) with long-standing IBD who were seen in tertiary care. Psychosocial assessments included psychological distress (Symptom Checklist-90R), social support (Social Support Questionnaire-6), perceived stress (Perceived Stress Scale-10), and recent minor stressful events (Weekly Stress Inventory). Disease activity was assessed with the Harvey Bradshaw Index. Patients reported higher levels of satisfaction with social support and smaller network sizes compared with normative values. Using multiple linear regression, the independent correlates of psychological distress (p = 0.0001; adjusted R2= 0.62) were as followsactive disease (p = 0.0234), less time since diagnosis (p = 0.0012), and greater number (p = 0.0001) and impact of stressful events (p = 0.0003). A statistically significant interaction term (p = 0.0171) revealed that the relationship between psychological distress and perceived stress changes depending on the level of satisfaction with social support. For patients with low levels of perceived stress, satisfaction with social support did not affect levels of psychological distress. However, for patients who experienced moderate to high levels of perceived stress, high satisfaction with social support decreased the level of psychological distress. These findings suggest that strategies aimed at improving social support can have a favorable impact on psychological distress and, ultimately, can improve health outcomes in patients with IBD.