Disease activity, behavioral dysfunction, and health-related quality of life in adolescents with inflammatory bowel disease
Open accessAbstract
BACKGROUND: Approximately 20%-25% of all inflammatory bowel disease (IBD) cases have an onset in childhood or adolescence. Beyond disease severity, little is known regarding determinants of health-related quality of life (HRQOL) in this population. This study aimed to identify behavioral correlates of HRQOL and examine behavioral/emotional dysfunction (e.g., internalizing/externalizing symptoms) as the mechanism through which disease severity impacts HRQOL. METHODS: In all, 62 adolescents (mean = 15.47 years, standard deviation [SD] = 1.42) with IBD (79% Crohn's disease) and their parents were recruited from one of two pediatric IBD specialty clinics located in the Midwest or Northeast region of the United States. Participants completed a demographic questionnaire, the Youth Self-Report version of the Child Behavior Checklist, and the IMPACT-III. Disease severity was calculated for Crohn's disease and ulcerative colitis using standardized measures. RESULTS: Greater disease severity, externalizing symptoms, and internalizing symptoms were all independently associated with lower HRQOL. Furthermore, internalizing symptoms partially mediated the relationship between disease activity and HRQOL, reducing the effect of disease severity on HRQOL from 22% to 9% in the mediation model. A Sobel test examining the significance of the indirect effect of disease severity on HRQOL via behavioral dysfunction was marginally nonsignificant (P =.053). CONCLUSIONS: Nondisease-specific variables (e.g., behavioral dysfunction) play an important role in impacting HRQOL. Behavioral dysfunction serves as the mechanism through which disease severity partially impacts HRQOL. Continued research to identify other predictors of HRQOL in pediatric IBD will greatly enhance our future ability to design interventions to improve HRQOL and maximize health outcomes.
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Difficulties in IBD self-management experienced by CA include impaired psychosocial function.
“Difficulties in IBD self-management experienced by CA include treatment non-adherence 8, 9 and impaired psychosocial function 10, 11 .”
From A Systematic review of self-management interventions for children and adolescents with inflammatory bowel disease (2019) · cites this paper as [11]
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- Authors
- Gray, W. N., Denson, L. A., Baldassano, R. N., & Hommel, K. A.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- Children's Hospital of Philadelphia (US)
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-07
- Volume
- 17
- Issue
- 7
- Pages
- 1581-1586
- ISSN
- 1078-0998 (ISSN-L)
- PMC
- PMC3117046
- OpenAlex
- W1966627325
- Cited by
- 86
- References
- 30
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 7 · 2021: 4 · 2020: 11 · 2019: 9 · 2018: 5 · 2017: 11 · 2016: 4 · 2015: 4 · 2014: 11 · 2013: 5 · 2012: 4
- FWCI
- 1.80
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Inflammatory Bowel Diseases (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5ul1rr026314-03)
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK079037, P30DK078392)
- National Center for Research Resources (1UL1RR026314, UL1-RR026314)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- inflammatory bowel disease, adolescents
- MeSH terms
- Adolescent, Adolescent Behavior, Child Behavior Disorders, Colitis, Ulcerative, Crohn Disease, Female, Humans, Male, Prognosis, Prospective Studies, Quality of Life, Surveys and Questionnaires, Self Concept
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