Short-Term Stress, but Not Mucosal Healing Nor Depression Was Predictive for the Risk of Relapse in Patients with Ulcerative Colitis: A Prospective 12-Month Follow-up Study
Abstract
BACKGROUND: Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease. Psychological factors such as depression and stress are under debate to contribute to the risk of relapse. The impact of mucosal healing to reduce the risk of relapse had not been studied prospectively. The aim of this study was to identify whether depression and stress increase and mucosal healing reduces the risk of clinical relapse in patients with UC in clinical remission. METHODS: Patients in clinical remission were followed prospectively for 1 year, or less if they relapsed. Endoscopy and histology score and long-term perceived stress (Perceived Stress Questionnaire) were measured at baseline. Mucosal healing was defined by a Mayo Endoscopy score of 0-1. Depression (Hospital Anxiety and Depression Scale) and acute perceived stress (Cohen Perceived Stress Scale) were measured at baseline and after 1, 3, 6, 9, and 12 months. A time-dependent multivariate Cox regression model determined the predictors of time to relapse. RESULTS: Seventy-five patients were included into final analysis, of which 28 (37.3%) relapsed. Short-term stress at the last visit before relapse (hazard ratio [HR] = 1.05, 95% confidence interval [CI] = 1.01-1.10) and male gender (HR = 2.38, 95% CI = 1.01-5.61), but not baseline mucosal healing (HR = 0.86, 95% CI = 0.35-2.11), baseline long-term stress (HR = 0.20, 95% CI = 0.01-3.31), and depression at the last visit before relapse (HR = 1.08, 95% CI = 0.95-1.22) were predictive for a relapse. CONCLUSIONS: Short-term stress but not depression nor mucosal healing was predictive for the risk of relapse in patients with UC in clinical remission. Larger multicentre studies are necessary to confirm our findings.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The most common stress measures were the Perceived Stress Questionnaire (PSQ) in 10 studies and the Perceived Stress Scale (PSS) in eight studies.
“The most common stress measures used were the Perceived Stress Questionnaire (PSQ) in 10 studies 25 , 29 , 30 , 34 , 35 , 37 , 39 , 41 , 42 , 49 and the Perceived Stress Scale (PSS) in eight studies. 12 , 15 , 24 , 27 , 29 , 31 , 46 , 55”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [29]
Seven of the studies examining stress with disease outcomes also examined psychosocial factors.
“with seven of these studies also examining psychosocial factors. 27 , 29 , 30 , 32 , 46 , 53 , 56”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [29]
The 13 eligible articles reported on 12 separate study populations containing 9192 patients.
“The 13 eligible articles reported on 12 separate study populations,[11, 20-30, 33] containing 9192 patients.”
From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [23]
Five included studies scored 7 or more on the Newcastle-Ottawa scale.
“Study quality is provided in Supplementary Tables 1 and 2; five studies scored 7 or more on the NewcastleOttawa scale.[11, 20, 23, 24, 26]”
From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [23]
When restricted to three studies recruiting only patients in clinical remission, there was no longer a significant increase in risk of flare among those with symptoms of depression at baseline (RR = 1.36; 95% CI 0.88-2.09).
“However, when the analysis was restricted to include only three studies that recruited only patients in clinical remission,[20, 23, 26] there was no longer a significant increase in risk (RR = 1.36; 95% CI 0.88-2.09).”
From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [23]
Pooled from eight studies including 7606 patients, symptoms of depression at baseline were associated with a significantly increased risk of flare of disease activity during longitudinal follow-up (RR = 1.60; 95% CI 1.21-2.12), with high heterogeneity (I2 = 73.5%).
“When data were pooled from eight studies,[20-23, 26, 27, 29, 30] which included 7606 patients, symptoms of depression at baseline were associated with a significantly increased risk of flare of disease activity during longitudinal follow-up (RR = 1.60; 95% CI 1.212.12), with high heterogeneity between studies ( I 2 =73.5%)”
From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [23]
In adults, rates of depression in inactive IBD ranged from 0 in one small study (n=33) to 49.6% (95% CI ±14.3) in another small study (n=47).
“In adults, the rates of depression in inactive IBD ranged from 0 in one small study (n=33) (18) to 49.6% (±14.3, 95% CI) in another small study (n=47) (40).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [40]
During active IBD, rates of depression ranged from 14% (95% CI ±18.2) in a small case-control study to 50% (±18.5) in a small prospective study (n=28).
“During active disease, the rates of depression ranged from 14% (± 18.2, 95% CI) in a small case-control study (18) to 50% (± 18.5, 95% CI) in a small prospective study (n=28) (40).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [40]
The pooled mean rate of depressive symptoms during active IBD was 34.7%.
“The pooled mean rate of depressive symptoms during active IBD was 34.7% (study n=5; total n=319) (18, 27, 29, 40, 48).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [40]
The pooled mean rate of depressive symptoms for inactive IBD was 19.9% (95% CI ±2.05).
“The pooled mean rate of depressive symptoms for those with inactive IBD was 19.9% (± 2.05, 95% CI) (study n=10; total n=1,132) (18, 27-29, 32, 33, 36, 39, 40, 48).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [40]
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139 · see citing works
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032 · see citing works
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
Development and validation of brief measures of positive and negative affect: The PANAS scales.
Watson, D., Clark, L. A., & Tellegen, A. (1988) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.54.6.1063 · Cited by 32,433 · see citing works
Coated Oral 5-Aminosalicylic Acid Therapy for Mildly to Moderately Active Ulcerative Colitis
Schroeder, K. W., Tremaine, W. J., & Ilstrup, D. M. (1987) · New England Journal of Medicine · doi:10.1056/nejm198712243172603 · Cited by 3,037 · see citing works
Herrmann, C. (1997) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(96)00216-4 · Cited by 2,885 · see citing works
Dichotomizing continuous predictors in multiple regression: a bad idea
Royston, P., Altman, D. G., & Sauerbrei, W. (2006) · Statistics in Medicine · doi:10.1002/sim.2331 · Cited by 2,312 · see citing works
Clinical prediction rules. A review and suggested modifications of methodological standards
Laupacis, A. (1997) · JAMA · doi:10.1001/jama.277.6.488 · Cited by 1,087 · see citing works
Rachmilewitz, D. (1989) · BMJ · doi:10.1136/bmj.298.6666.82 · Cited by 1,038 · see citing works
Development of the perceived stress questionnaire: A new tool for psychosomatic research
Levenstein, S., Prantera, C., Varvo, V., Scribano, M. L., Berto, E., Luzi, C., & Andreoli, A. (1993) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(93)90120-5 · Cited by 985 · see citing works
Laupacis, A. (1997) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1997.03540300056034 · Cited by 793 · see citing works
Depression and anxiety in inflammatory bowel disease: A review of comorbidity and management
Graff, L. A., Walker, J. R., & Bernstein, C. N. (2009) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20873 · Cited by 586 · see citing works
Mittermaier, C., Dejaco, C., Waldhoer, T., Oefferlbauer-Ernst, A., Miehsler, W., Beier, M., Tillinger, W., Gangl, A., & Moser, G. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000106907.24881.f2 · Cited by 532 · see citing works
Fliege, H., Rose, M., Arck, P., Walter, O. B., Kocalevent, R.-D., Weber, C., & Klapp, B. F. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000151491.80178.78 · Cited by 496 · see citing works
Clinical, biological, and histologic parameters as predictors of relapse in ulcerative colitis
Bitton, A., Peppercorn, M. A., Antonioli, D. A., Niles, J. L., Shah, S. A., Bousvaros, A., Ransil, B. J., Wild, G., Cohen, A., Edwardes, M. D. D., et al. (2001) · Gastroenterology · doi:10.1053/gast.2001.20912 · Cited by 489 · see citing works
Stress and Exacerbation in Ulcerative Colitis: A Prospective Study of Patients Enrolled in Remission
Levenstein, S., Prantera, C., Varvo, V., Scribano, M. L., Andreoli, A., Luzi, C., Arcà, M., Berto, E., Milite, G., & Marcheggiano, A. (2000) · American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2000.02012.x · Cited by 451 · see citing works
A prospective population-based study of triggers of symptomatic flares in IBD
Bernstein, C. N., Singh, S., Graff, L. A., Walker, J. R., Miller, N., & Cheang, M. (2010) · American Journal of Gastroenterology · doi:10.1038/ajg.2010.140 · Cited by 400 · see citing works
Gastrointestinal Illness and the Biopsychosocial Model
Drossman, D. A. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199805000-00007 · Cited by 388 · see citing works
Haddock, C., Rindskopf, D., & Shadish, W. (1998) · Psychological Methods · doi:10.1037/1082-989x.3.3.339 · Cited by 349 · see citing works
Predicting relapse in Crohn’s disease: a biopsychosocial model
Bitton, A., Dobkin, P. L., Edwardes, M. D., Sewitch, M. J., Meddings, J. B., Rawal, S., Cohen, A., Vermeire, S., Dufresne, L., Franchimont, D., et al. (2008) · Gut · doi:10.1136/gut.2007.134817 · Cited by 254 · see citing works
Psychosocial determinants of relapse in ulcerative colitis: A longitudinal study
Bitton, A., Sewitch, M. J., Peppercorn, M. A., de B Edwardes, M. D., Shah, S., Ransil, B., & Locke, S. E. (2003) · American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2003.07717.x · Cited by 226 · see citing works
Review article: defining remission in ulcerative colitis
Travis, S. P. L., Higgins, P., Orchard, T. R., van der Woude, C. J., Panaccione, R., Bitton, A., O'Morain, C. A., Panés, J., Sturm, A., Reinisch, W., et al. (2011) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2011.04701.x · Cited by 211 · see citing works
Maunder, R., & Levenstein, S. (2008) · Current Molecular Medicine · doi:10.2174/156652408784533832 · Cited by 198 · see citing works
Why do patients with ulcerative colitis relapse?
Riley, S. A., Mani, V., Goodman, M. J., & Lucas, S. B. (1990) · Gut · doi:10.1136/gut.31.2.179 · Cited by 182 · see citing works
Elsenbruch, S., Langhorst, J., Popkirowa, K., Müller, T., Luedtke, R., Franken, U., Paul, A., Spahn, G., Michalsen, A., Janssen, O., et al. (2005) · Psychotherapy and Psychosomatics · doi:10.1159/000086318 · Cited by 181 · see citing works
Self-citationAnxiety and depression in patients with inflammatory bowel disease
Häuser, W., Janke, K.-H., Klump, B., & Hinz, A. (2010) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21346 · Cited by 163 · see citing works
Self-citationSainsbury, A., & Heatley, R. V. (2005) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2005.02380.x · Cited by 160 · see citing works
The Natural History of Ulcerative Proctitis: A Multicenter, Retrospective Study
Meucci, G., Vecchi, M., Astegiano, M., Beretta, L., Cesari, P., Dizioli, P., Ferraris, L., Panelli, M. R., Prada, A., Sostegni, R., et al. (2000) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2000.t01-1-01770.x · Cited by 154 · see citing works
Mucosal healing in inflammatory bowel disease-a true paradigm of success?
Dave, M., & Loftus, E. V. (2012) · PubMed Central · Cited by 134 · see citing works
Outcome measurement in clinical trials for ulcerative colitis: towards standardisation
Cooney, R. M., Warren, B. F., Altman, D. G., Abreu, M. T., & Travis, S. P. L. (2007) · Trials · doi:10.1186/1745-6215-8-17 · Cited by 128 · see citing works
Langhorst, J., Anthonisen, I. B., Steder-Neukamm, U., Lüdtke, R., Spahn, G., Michalsen, A., & Dobos, G. (2005) · Inflammatory Bowel Diseases · doi:10.1097/01.mib.0000160771.71328.6c · Cited by 126 · see citing works
Self-citationBoye, B., Lundin, K. E. A., Jantschek, G., Leganger, S., Mokleby, K., Tangen, T., Jantschek, I., Pripp, A. H., Wojniusz, S., Dahlstroem, A., et al. (2011) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21575 · Cited by 113 · see citing works
Cámara, R. J. A., Ziegler, R., Begré, S., Schoepfer, A. M., & von Känel, R. (2009) · Digestion · doi:10.1159/000226087 · Cited by 106 · see citing works
Long-term monitoring of psychosocial stress and symptomatology in inflammatory bowel disease
Greene, B. R., Blanchard, E. B., & Wan, C. K. (1994) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)90114-7 · Cited by 100 · see citing works
The 10 remaining mysteries of inflammatory bowel disease
Colombel, J. F., Watson, A. J. M., & Neurath, M. (2007) · Gut · doi:10.1136/gut.2007.122192 · Cited by 63 · see citing works
Management of stress in inflammatory bowel disease: a therapeutic option?
Goodhand, J., Wahed, M., & Rampton, D. S. (2009) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/egh.09.55 · Cited by 56 · see citing works
Mikocka‐Walus, A. A., Turnbull, D. A., Moulding, N., Wilson, I. G., Holtmann, G., & Andrews, J. M. (2008) · BioPsychoSocial Medicine · doi:10.1186/1751-0759-2-11 · Cited by 54 · see citing works
Stress-related peripheral neuroendocrine–immune interactions in women with ulcerative colitis
Langhorst, J., Cobelens, P. M., Kavelaars, A., Heijnen, C. J., Benson, S., Rifaie, N., Dobos, G. J., Schedlowski, M., & Elsenbruch, S. (2007) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2007.09.003 · Cited by 35 · see citing works
Self-citationBello, C. D., Bélaïche, J., Louis, E., & Reenaers, C. (2011) · Journal of Crohn s and Colitis · doi:10.1016/j.crohns.2010.12.011 · Cited by 34 · see citing works
Controversies in mucosal healing in ulcerative colitis
Kane, S. V., Lu, F., Kornbluth, A. A., Awais, D., & Higgins, P. (2009) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20875 · Cited by 28 · see citing works
Mucosal Healing in Ulcerative Colitis: Where do we Stand?
Fiorino, G., Cesarini, M., Indriolo, A., & Malesci, A. (2011) · Current Drug Targets · doi:10.2174/138945011796818216 · Cited by 18 · see citing works
El papel de la ansiedad y la depresión en las recidivas de la enfermedad inflamatoria intestinal
Vidal, Á., Gómez‐Gil, E., Sans, M., Portella, M. J., Salamero, M., Pique, J. M., & Panés, J. (2009) · Medicina Clínica · doi:10.1016/j.medcli.2008.07.002 · Cited by 12 · see citing works
Treatment of inflammatory bowel diseases: To heal the wound or to heal the sick?
Caprilli, R., Latella, G., & Frieri, G. (2012) · Journal of Crohn s and Colitis · doi:10.1016/j.crohns.2012.02.009 · Cited by 11 · see citing works
Prenzler, A., Bokemeyer, B., Mittendorf, T., & von der Schulenburg, J. G. (2010) · DMW - Deutsche Medizinische Wochenschrift · doi:10.1055/s-0029-1244848 · Cited by 10 · see citing works
[Relapse rates of ulcerative colitis in remission and factors related to relapse].
Park, B. J., Lee, K. J., Hwang, J. C., Sin, S. J., Chung, J. Y., & Cho, S. W. (2008) · PubMed · Cited by 8 · see citing works
Flagged first, then by citations
1 of the 47 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Mikocka-Walus, A., Knowles, S. R., Keefer, L., & Graff, L. (2016) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000000620 · Cited by 567 · see citing works
ACG clinical guideline: Preventive care in inflammatory bowel disease
Farraye, F. A., Melmed, G. Y., Lichtenstein, G. R., & Kane, S. V. (2017) · American Journal of Gastroenterology · doi:10.1038/ajg.2016.537 · Cited by 473 · see citing works
Bi-directionality of brain–gut interactions in patients with inflammatory bowel disease
Gracie, D. J., Guthrie, E. A., Hamlin, P. J., & Ford, A. C. (2018) · Gastroenterology · doi:10.1053/j.gastro.2018.01.027 · Cited by 408 · see citing works
Gracie, D. J., Hamlin, P. J., & Ford, A. C. (2019) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(19)30089-5 · Cited by 358 · see citing works
Mikocka-Walus, A., Pittet, V., Rossel, J.-B., von Känel, R., Anderegg, C., Bauerfeind, P., Beglinger, C., Begré, S., Belli, D., Bengoa, J. M., et al. (2016) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2015.12.045 · Cited by 348 · see citing works
Fairbrass, K. M., Lovatt, J., Barberio, B., Yuan, Y., Gracie, D. J., & Ford, A. C. (2022) · Gut · doi:10.1136/gutjnl-2021-325985 · Cited by 225 · see citing works
Effect of Lifestyle Factors on Outcomes in Patients With Inflammatory Bowel Diseases
Rozich, J. J., Holmer, A. K., & Singh, S. (2020) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000000608 · Cited by 205 · see citing works
Labanski, A., Langhorst, J., Engler, H., & Elsenbruch, S. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.104501 · Cited by 200 · see citing works
Self-citationLanghorst, J., Wulfert, H., Lauche, R., Klose, P., Cramer, H., Dobos, G., & Korzenik, J. R. (2014) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jju007 · Cited by 198 · see citing works
Self-citationAbautret-Daly, Á., Dempsey, E., Parra‐Blanco, A., Medina, C., & Harkin, A. (2017) · Acta Neuropsychiatrica · doi:10.1017/neu.2017.3 · Cited by 185 · see citing works
Targownik, L. E., Sexton, K. A., Bernstein, M. T., Beatie, B., Sargent, M., Walker, J. R., & Graff, L. A. (2015) · American Journal of Gastroenterology · doi:10.1038/ajg.2015.147 · Cited by 157 · see citing works
Etiology and Treatment of Pain and Psychosocial Issues in Patients With Inflammatory Bowel Diseases
Regueiro, M., Greer, J. B., & Szigethy, E. (2017) · Gastroenterology · doi:10.1053/j.gastro.2016.10.036 · Cited by 142 · see citing works
Randomised clinical trial: yoga vs written self‐care advice for ulcerative colitis
Cramer, H., Schäfer, M., Schöls, M., Köcke, J., Elsenbruch, S., Lauche, R., Engler, H., Dobos, G. J., & Langhorst, J. (2017) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.14062 · Cited by 135 · see citing works
Self-citationThe relationship between symptoms of depression and anxiety and disease activity in IBD over time
Marrie, R. A., Graff, L. A., Fisk, J. D., Patten, S. B., & Bernstein, C. N. (2021) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izaa349 · Cited by 128 · see citing works
The Brain-Gut Axis: Psychological Functioning and Inflammatory Bowel Diseases
Peppas, S., Pansieri, C., Piovani, D., Danese, S., Peyrin‐Biroulet, L., Tsantes, A. G., Brunetta, E., Tsantes, A. Ε., & Bonovas, S. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10030377 · Cited by 114 · see citing works
The role of stress in the mosaic of autoimmunity: An overlooked association
Sharif, Κ., Watad, ., Coplan, L., Lichtbroun, B., Krosser, A., Lichtbroun, M., Bragazzi, N. L., Amital, H., Afek, A. B., & Shoenfeld, Y. (2018) · Autoimmunity Reviews · doi:10.1016/j.autrev.2018.04.005 · Cited by 111 · see citing works
Psychological stress and depression: risk factors for IBD
Bernstein, C. N. (2016) · Digestive Diseases · doi:10.1159/000442929 · Cited by 107 · see citing works
The Brain-Gut Axis and Stress in Inflammatory Bowel Disease
Bernstein, C. N. (2017) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2017.08.006 · Cited by 99 · see citing works
Dubinsky, M. C., Dotan, I., Rubin, D. T., Bernauer, M. J., Patel, D. A., Cheung, R. Y., Modesto, I., Latymer, M., & Keefer, L. (2021) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2021.1911644 · Cited by 92 · see citing works
Wang, S., Shao, B., Zhao, S., Chang, X., Wang, P., Miao, C., Li, Z., & Bai, Y. (2019) · Cell Death and Disease · doi:10.1038/s41419-019-1634-x · Cited by 86 · see citing works
Langhorst, J., Boone, J. H., Lauche, R., Rueffer, A., & Dobos, G. (2016) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjw044 · Cited by 83 · see citing works
Self-citationSexton, K. A., Walker, J. R., Graff, L. A., Bernstein, M. T., Beatie, B., Miller, N., Sargent, M., & Targownik, L. E. (2017) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000001040 · Cited by 79 · see citing works
Sturm, A., Stallmach, A., Atreya, R. N., Bettenworth, D., Bokemeyer, B., Dignass, A. U., Ehehalt, R., Germer, C. T., Grunert, P., Helwig, U., et al. (2022) · Zeitschrift für Gastroenterologie · doi:10.1055/a-1713-3941 · Cited by 77 · see citing works
Self-citationHorst, S., Chao, A., Rosen, M., Nohl, A., Duley, C., Wagnon, J. H., Beaulieu, D. B., Taylor, W., Gaines, L., & Schwartz, D. A. (2015) · Digestive Diseases and Sciences · doi:10.1007/s10620-014-3375-0 · Cited by 75 · see citing works
Psychosocial issues in evidence-based guidelines on inflammatory bowel diseases: A review
Häuser, W. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i13.3663 · Cited by 70 · see citing works
Self-citationAlexakis, C., Kumar, S., Saxena, S., & Pollok, R. (2017) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.14171 · Cited by 69 · see citing works
Systematic review: the role of psychological stress in inflammatory bowel disease
Black, J., Sweeney, L., Yuan, Y., Singh, H., Norton, C., & Czuber‐Dochan, W. (2022) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17202 · Cited by 65 · see citing works
Araki, M., Shinzaki, S., Yamada, T., Arimitsu, S., Komori, M., Shibukawa, N., Mukai, A., Nakajima, S., Kinoshita, K., Kitamura, S., et al. (2020) · PLOS ONE · doi:10.1371/journal.pone.0233365 · Cited by 65 · see citing works
Fairbrass, K. M., Gracie, D. J., & Ford, A. C. (2022) · Gastroenterology · doi:10.1053/j.gastro.2022.03.014 · Cited by 63 · see citing works
Hirten, R. P., Danieletto, M., Scheel, R., Shervey, M., Ji, J., Hu, L., Sauk, J., Chang, L., Arnrich, B., Bӧttinger, E., et al. (2021) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izaa323 · Cited by 60 · see citing works
Wintjens, D., de Jong, M. J., Jong, A. E. V. D. M., Romberg-Camps, M. J. L., Becx, M. C., Maljaars, J., Bodegraven, A. A. V., Mahmmod, N., Markus, T., Haans, J. J. L., et al. (2018) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjy177 · Cited by 48 · see citing works
High Perceived Stress is Associated With Increased Risk of Ulcerative Colitis Clinical Flares
Sauk, J. S., Ryu, H. J., Labus, J. S., Khandadash, A., Ahdoot, A., Lagishetty, V., Katzka, W. R., Wang, H., Naliboff, B. D., Jacobs, J. P., et al. (2022) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2022.07.025 · Cited by 44 · see citing works
Environmental Triggers for IBD
O’Toole, A., & Korzenik, J. R. (2014) · Current Gastroenterology Reports · doi:10.1007/s11894-014-0396-y · Cited by 44 · see citing works
ACG Clinical Guideline Update: Preventive Care in Inflammatory Bowel Disease
Farraye, F. A., Melmed, G., Lichtenstein, G. R., Barnes, E. L., Limketkai, B. N., Caldera, F., & Kane, S. V. (2025) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000003541 · Cited by 44 · see citing works
Schoultz, M., Beattie, M., Gorely, T., & Leung, J. (2020) · Systematic Reviews · doi:10.1186/s13643-020-01426-2 · Cited by 36 · see citing works
Dolovich, C., Bernstein, C. N., Singh, H., Nugent, Z. J., Tennakoon, A., Shafer, L. A., Marrie, R. A., Sareen, J., & Targownik, L. E. (2020) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2020.07.013 · Cited by 35 · see citing works
The role of hypnotherapy for the treatment of inflammatory bowel diseases
Moser, G. (2014) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/17474124.2014.917955 · Cited by 33 · see citing works
Moradi, S., Zobeiri, M., Feizi, A., Clark, C. C. T., & Entezari, M. H. (2021) · International Journal of Clinical Practice · doi:10.1111/ijcp.14472 · Cited by 32 · see citing works
Sturm, A., Atreya, R. N., Bettenworth, D., Bokemeyer, B., Dignass, A. U., Ehehalt, R., Germer, C.-T., Grunert, P., Helwig, U., Horisberger, K., et al. (2024) · Zeitschrift für Gastroenterologie · doi:10.1055/a-2309-6123 · Cited by 33 · see citing works
Self-citationReed-Knight, B., van Tilburg, M. A. L., Levy, R. L., Langer, S. L., Romano, J. M., Murphy, T. B., DuPen, M. M., & Feld, A. D. (2018) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsx082 · Cited by 30 · see citing works
Koch, A. K., Schöls, M., Langhorst, J., Dobos, G., & Cramer, H. (2020) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2019.109917 · Cited by 29 · see citing works
Self-citationAsscher, V. E. R., Kong, V. Y., Kort, E. D., van Deudekom, F. J., Mooijaart, S. P., & Maljaars, J. (2019) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjz082 · Cited by 29 · see citing works
Mackner, L. M., Hatzakis, E., Allen, J. M., Davies, R. H., Kim, S. C., Maltz, R. M., & Bailey, M. T. (2019) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.104469 · Cited by 29 · see citing works
Riggott, C., Ford, A. C., & Gracie, D. J. (2024) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.18192 · Cited by 30 · see citing works
Psychological distress in inflammatory bowel disease
Balestrieri, P., Cicala, M., & Ribolsi, M. (2023) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2023.2209723 · Cited by 25 · see citing works
Bauer, N., Kairey, L., Schlee, C., Uecker, C., Öznur, Ö., & Langhorst, J. (2022) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365521.2022.2078667 · Cited by 23 · see citing works
Self-citationZingone, F., Siniscalchi, M., Savarino, E. V., Barberio, B., Cingolani, L., Renata D'Incà, de Filippo, F. R., Camera, S., & Ciacci, C. (2020) · Journal of Medical Internet Research · doi:10.2196/19574 · Cited by 20 · see citing works
Bakkum, L., Willemen, A. M., Zoetebier, L., & Bouts, A. H. M. (2019) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2019.01.011 · Cited by 19 · see citing works
Carlo, C. D., Bramuzzo, M., Canaletti, C., Udina, C., Cozzi, G., Pavanello, P. M., Rampado, S., Martelossi, S., Giudici, F., Leo, G. D., et al. (2019) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000002447 · Cited by 19 · see citing works
Jacobs, J. P., Sauk, J. S., Ahdoot, A., Liang, F., Katzka, W. R., Ryu, H. J., Khandadash, A., Lagishetty, V., Labus, J. S., Naliboff, B. D., et al. (2023) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izad185 · Cited by 19 · see citing works
Psychological Aspects of Inflammatory Bowel Disease in Children and Adolescents
Reed, B., Mackner, L. M., & Crandall, W. (2017) · Springer eBooks · doi:10.1007/978-3-319-49215-5_50 · Cited by 17 · see citing works
Öhlmann, H., Koenen, L. R., Labrenz, F., Engler, H., Theysohn, N., Langhorst, J., & Elsenbruch, S. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.733035 · Cited by 15 · see citing works
Self-citationSystematic review and meta‐analysis: Impact of depression on prognosis in inflammatory bowel disease
Ji, Y., Li, H., Dai, G., Zhang, X., & Ju, W. (2024) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.16568 · Cited by 15 · see citing works
Metabolomics facilitate the personalized management in inflammatory bowel disease
Chen, R., Zheng, J., Li, L., Li, C., Chao, K., Zeng, Z., Chen, M., & Zhang, S. (2021) · Therapeutic Advances in Gastroenterology · doi:10.1177/17562848211064489 · Cited by 14 · see citing works
Koch, A. K., Schöls, M., Haller, H., Anheyer, D., Cinar, Z., Eilert, R., Kofink, K., Engler, H., Elsenbruch, S., Cramer, H., et al. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10215070 · Cited by 14 · see citing works
Self-citationCushman, G. K., Shih, S. W., Stolz, M. G., Hinrichs, R. C., Jovanović, T., Lee, J. L., Kugathasan, S., & Reed, B. (2020) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2020.110323 · Cited by 13 · see citing works
Riggott, C., Fairbrass, K. M., Gracie, D. J., & Ford, A. C. (2025) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.70068 · Cited by 13 · see citing works
Parian, A. M., Mullin, G. E., Langhorst, J., & Brown, A. C. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-35868-2.00050-5 · Cited by 14 · see citing works
Self-citationOyama, H., Moroi, R., Tarasawa, K., Shimoyama, Y., Naito, T., Sakuma, A., Shiga, H., Kakuta, Y., Fushimi, K., Fujimori, K., et al. (2022) · JGH Open · doi:10.1002/jgh3.12836 · Cited by 11 · see citing works
Öhlmann, H., Lanters, L. R., Theysohn, N., Langhorst, J., Engler, H., Icenhour, A., & Elsenbruch, S. (2023) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjad080 · Cited by 10 · see citing works
Self-citationBauer, N., Löffler, C., Öznur, Ö., Uecker, C., Keil, T. O. P., & Langhorst, J. (2022) · Frontiers in Integrative Neuroscience · doi:10.3389/fnint.2022.960301 · Cited by 10 · see citing works
Self-citationOh, S. J., Choi, C. H., Jung, S.-A., Song, G. A., Kim, Y. J., Koo, J. S., Shin, S. J., Seo, G. S., Lee, K., Jang, B. I., et al. (2024) · Gut and Liver · doi:10.5009/gnl240146 · Cited by 9 · see citing works
Factors Associated with Mucosal Healing in Patients with Ulcerative Colitis in Clinical Remission
Shi, H. Y., Chan, F. K. L., Tsang, S. W., Hui, Y. T., Sze, S. F., Ching, J. Y. L., Chung, T., Iu, C. Y. Y., Lo, F. H., Shan, E. H. S., et al. (2015) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000000334 · Cited by 7 · see citing works
Incidence of Ulcerative Colitis Relapse: A Prospective Cohort Study in Southern Iran
Hosseini, S. V., Taghavi, S. A., Jafari, P., Rezaianzadeh, A., Moini, M., Mehrabi, M., Sepehrimanesh, M., & Safarpour, A. R. (2016) · Annals of Colorectal Research · doi:10.17795/acr-34565 · Cited by 7 · see citing works
Shah, R., Kelley, J., Amundsen, T., Coggins, K. G., Edwards, A. S., & Johnson, C. M. (2022) · Baylor University Medical Center Proceedings · doi:10.1080/08998280.2022.2156025 · Cited by 6 · see citing works
Mechanisms of chronic abdominal pain in inflammatory bowel disease and implications for treatment
Defaye, M., Nasser, Y., & Altier, C. (2025) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-025-01139-8 · Cited by 5 · see citing works
Seaton, N., Hudson, J. L., Mondelli, V., Raymond, L., Schmill, P., Hart, A. L., & Moss-Morris, R. E. (2025) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2025.101147 · Cited by 4 · see citing works
Rea, K. E., Cushman, G. K., Westbrook, A. L., & Reed, B. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.111143 · Cited by 4 · see citing works
Association of Childhood Abuse With Incident Inflammatory Bowel Disease
Anyane‐Yeboa, A., Casey, K. J., Roberts, A. L., Lopes, E. W., Burke, K. E., Ananthakrishnan, A. N., Richter, J. M., Cozier, Y. C., Koenen, K. C., Chan, A. T., et al. (2024) · Clinical and Translational Gastroenterology · doi:10.14309/ctg.0000000000000718 · Cited by 4 · see citing works
Schlee, C., Uecker, C., Öznur, Ö., Bauer, N., & Langhorst, J. (2024) · PLoS ONE · doi:10.1371/journal.pone.0313127 · Cited by 4 · see citing works
Self-citationHmar, E. B. L., Paul, S., Boruah, N., Sarkar, P., Borah, S., & Sharma, H. K. (2021) · Current Pathobiology Reports · doi:10.1007/s40139-020-00218-6 · Cited by 4 · see citing works
Langhorst, J., & Lauche, R. (2014) · Digestion · doi:10.1159/000357368 · Cited by 4 · see citing works
Self-citationA review of the link between psychological stress and inflammatory bowel disease exacerbation
Klettner, A. M., Luo, S., Coyle, L. D., & Liu, N. (2025) · Academia Mental Health and Well-Being · doi:10.20935/mhealthwellb7617 · Cited by 3 · see citing works
Psychological Stress and the Kaleidoscope of Autoimmune Diseases
Sharif, Κ., Watad, ., Krosser, A., Coplan, L., Amital, H., Afek, A. B., & Shoenfeld, Y. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-814307-0.00033-5 · Cited by 3 · see citing works
Lifestyle Intervention Modulates the CD4+ T Cell Profile in the Blood of Crohn’s Disease Patients
Mekes-Adamczyk, A., Gausmann, N., Öznur, Ö., Pfuhlmann, K., Dziobaka, J., Buer, J., Langhorst, J., & Westendorf, A. M. (2024) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izae154 · Cited by 2 · see citing works
Self-citationVisceral Pain: From Bench to Bedside
Elsenbruch, S., & Benson, S. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-805408-6.00019-1 · Cited by 2 · see citing works
Häuser, W. (2020) · Springer eBooks · doi:10.1007/978-3-662-59104-8_36 · Cited by 1 · see citing works
Self-citationDobos, G. (2018) · MMW - Fortschritte der Medizin · doi:10.1007/s15006-018-0917-y · Cited by 1 · see citing works
Naturheilkunde und Komplementärmedizin bei chronisch entzündlichen Darmerkrankungen
Langhorst, J. (2016) · Journal für Kardiologie (Krause & Pachernegg GmbH) · Cited by 1 · see citing works
Self-citationChronisch-entzündliche Darmerkrankungen
Langhorst, J., & Koch, A. K. (2024) · Springer eBooks · doi:10.1007/978-3-662-68436-8_11 · Cited by 1 · see citing works
Self-citationThe Different Drummer: Non-traditional Therapeutic Approaches
Yen, E. F. (2017) · Clinical gastroenterology · doi:10.1007/978-3-319-53763-4_12
OBSOLETE: Visceral Pain: From Bench to Bedside
Elsenbruch, S. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-809324-5.00019-5
Carlo, C. D., & Bramuzzo, M. (2020) · Medico e Bambino · doi:10.53126/meb39634
(2016) · Elsevier eBooks · doi:10.1016/b978-3-437-21833-0.16001-2
Langhorst, J. (2023) · Springer eBooks · doi:10.1007/978-3-662-64938-1_16
Self-citation
- Authors
- Langhorst, J., Hofstetter, A., Wolfe, F., & Häuser, W.
- Affiliations
- University of Kansas (US)
- Kliniken Essen-Mitte (DE)
- Klinikum Saarbrücken (DE)
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-10
- Volume
- 19
- Issue
- 11
- Pages
- 2380-2386
- ISSN
- 1078-0998 (ISSN-L)
- OpenAlex
- W2033892467
- Cited by
- 85
- References
- 47
- Citations by year
- 2025: 5 · 2024: 8 · 2023: 4 · 2022: 9 · 2021: 9 · 2020: 11 · 2019: 9 · 2018: 4 · 2017: 10 · 2016: 8 · 2015: 2 · 2014: 6
- FWCI
- 3.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Inflammatory Bowel Diseases (publishedVersion)
- PubMed (publishedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Health Sciences › Medicine › Epidemiology › Microscopic Colitis
- Keywords
- ulcerative colitis, relapse risk
- MeSH terms
- Colitis, Ulcerative, Depression, Endoscopy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Recurrence, Stress, Physiological, Time Factors, Wound Healing
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.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
