Crohn's Disease: A Two-Year Prospective Study of the Association Between Psychological Distress and Disease Activity

Mardini, Houssam E.; Kip, Kevin E.; Wilson, John W.

doi:10.1023/b:ddas.0000020509.23162.cc

Cited by 211Inflammatory Bowel DiseaseTryptophan and brain disordersPsychosomatic Disorders and Their Treatments

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Crohn's Disease: A Two-Year Prospective Study of the Association Between Psychological Distress and Disease Activity

Mardini, Houssam E., Kip, Kevin E., Wilson, John W.·2004·Digestive Diseases and Sciences

DOI 10.1023/b:ddas.0000020509.23162.cc

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Abstract

Our objective was to explore the relationship between psychological distress and subsequent Crohn's disease (CD) activity. Eighteen CD patients were followed prospectively for 2 years at 8- to 12-week intervals. Disease activity was assessed using the Crohn's Disease Activity Index (CDAI). Psychological distress was assessed using the following self-administered questionnaires: Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Beck Hopelessness Scale (BHS), and multiple Holmes Recent Life Changes (RLC) Questionnaires. The effects of psychological distress on current and subsequent CDAI (approximately 8-12 weeks later) were assessed using generalized estimating equations (GEE). The mean CDAI score during follow-up was 138 +/- 86, with a median of 121 (range, 0 to 394). BDI scores (possible range of 0 to 63) were independently associated with CDAI scores simultaneously (beta = 5.64, P = 0.004) and 8-12 weeks later (beta = 6.08, P = 0.004). Higher levels of anxiety, hopelessness, and recent life changes were also suggestive of higher CDAI scores, however, their effects were generally of lesser magnitude and not independent of the influence of depressive symptoms. Levels of depressive symptoms are positively associated with future changes in CDAI. Routine psychological assessment may help to identify patients at higher risk for exacerbation.

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When distress was measured with separate depression, anxiety and hopelessness indices, depression was associated with disease exacerbation 8-12 weeks later.
“but when distress was measured with separate depression, anxiety and hopelessness indices, depression was associated with disease exacerbation 8–12 weeks later. 47”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [47]

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Crohn?s disease: a two-year prospective study of the association between psychological distress and subsequent disease activity
Mardini, H. E. (2003) · The American Journal of Gastroenterology · doi:10.1016/s0002-9270(03)01520-x
Self-citation
Depression Is Associated With Subjective Measures of Crohn's Disease Activity During Longitudinal Follow-up
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P0886 The association of psychological factors and future exacerbation of Inflammatory activity in Crohn’s Disease: A prospective Cohort Study
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Untitled work
(2009) · PubMed · Cited by 14
Psychological distress links to magnetic resonance enterography abnormalities in Crohn’s disease
Zhang, R., Ke, Y., Cai, H., Wang, Y., Huang, L., Shen, X., Zheng, Q., Wu, L., Zhao, Q., Zheng, W., et al. (2026) · Insights into Imaging · doi:10.1186/s13244-026-02273-w

Authors: Mardini, H. E., Kip, K. E., & Wilson, J. W.
Affiliations: University of Kentucky (US)
University of Pittsburgh (US)
Corresponding author: Mardini, Houssam E.
ORCID: Kip, Kevin E.
Venue: Digestive Diseases and Sciences
Publisher: Springer Science and Business Media LLC
Published: 2004-03
Volume: 49
Issue: 3
Pages: 492-497
ISSN: 0163-2116 (ISSN-L)
1573-2568
DOI: 10.1023/b:ddas.0000020509.23162.cc
OpenAlex: W2142347208
Cited by: 211
References: 40
Citations by year: 2026: 3 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 10 · 2021: 12 · 2020: 9 · 2019: 13 · 2018: 10 · 2017: 9 · 2016: 13 · 2015: 8 · 2014: 6 · 2013: 11 · 2012: 7
FWCI: 6.35
Type: journal article
Language: en
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Digestive Diseases and Sciences (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords: Crohn's disease, psychological distress, disease activity, depressive symptoms, anxiety, hopelessness, CDAI, disease exacerbation, psychological assessment
MeSH terms: Adult, Anxiety, Crohn Disease, Depression, Female, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Stress, Psychological

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Crohn's Disease: A Two-Year Prospective Study of the Association Between Psychological Distress and Disease Activity

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