Reconsidering the methodology of “stress” research in inflammatory bowel disease
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BACKGROUND AND AIMS: The goals of this paper are: 1) to critically review and analyze the methodology of the studies since 1990 linking stress to inflammatory bowel disease; and 2) to make recommendations for future research in this area of research. METHODS: Articles were restricted to empirical reports in the English language with human subjects. Eleven empirical articles were able to answer "How is psychological stress related to inflammation and/or the expression or course of inflammatory bowel disease?" RESULTS: Studies varied by choice of participant groups, method for classifying disease activity, choice of design, and definition and measurement of stress. Only half of the studies supported the hypothesis that stress affected IBD in some way. CONCLUSIONS: Current methodological limitations in the stress and gut inflammation research have made it difficult for us to ascertain the role of stress in inflammatory bowel disease. Authors provide a checklist of items to consider when designing future studies.
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Previous systematic reviews have found a significant association between stress and IBD disease activity in 6/11 studies.
“and 6/11 studies 18 reviewed.”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [18]
The Results and discussion report that six of eleven studies supported the hypothesis that stress affects IBD in some way. The source does not say that all six found a statistically significant association specifically with disease activity; the Conclusion also cautions that methodological problems prevent firm conclusions. (LLM, conf=0.87)
Experimental — accuracy not yet measuredPrevious reviews have raised concerns about heterogeneity in study design, participant samples and disease activity and stress measures that have made establishing the relationship between stress and disease activity difficult.
“These reviews have raised concerns about heterogeneity in study design, participant samples and disease activity and stress measures that have made establishing the relationship between stress and disease activity difficult. 7 , 17 , 18”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [18]
A manual search of citations did not result in any additional inclusions.
“A manual search of citations in previous systematic reviews 17 , 18 and included studies did not result in any additional inclusions.”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [18]
References were searched from included studies and previous systematic reviews to ensure all relevant papers were included.
“References were searched from included studies and previous systematic reviews 17 , 18 to ensure all relevant papers were included.”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [18]
Researchers have recruited heterogeneous samples (both in terms of IBD subtypes and baseline disease activity), despite recommendations to the contrary.
“Researchers have recruited heterogeneous samples (both in terms of IBD subtypes and baseline disease activity), despite recommendations to the contrary. 7 , 17 , 18”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [18]
The review updated the findings of previous reviews including 21 more recent studies from the last decade.
“Moreover, we were able to update the findings of previous reviews 17 , 18 including 21 more recent studies from the last decade.”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [18]
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- Authors
- Keefer, L., Keshavarzian, A., & Mutlu, E.
- Affiliations
- Rush University Medical Center (US)
- Corresponding author
- Keefer, Laurie
- Venue
- Journal of Crohn's and Colitis
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-09
- Volume
- 2
- Issue
- 3
- Pages
- 193-201
- ISSN
- 1873-9946 (ISSN-L)
- PMC
- PMC3049955
- OpenAlex
- W2036281919
- Cited by
- 56
- References
- 76
- Citations by year
- 2025: 4 · 2024: 5 · 2023: 5 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 2 · 2018: 7 · 2017: 4 · 2016: 2 · 2015: 5 · 2014: 2 · 2013: 3 · 2012: 3
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Crohn s and Colitis (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Complementary and Integrative Health (R21AT003204)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- psychological stress, inflammatory bowel disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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