Psychological disorder and severity of inflammatory bowel disease predict health-related quality of life in ulcerative colitis and Crohn's disease
Abstract
OBJECTIVE: The determinants of health-related quality of life in inflammatory bowel disease are not completely understood. The present study aimed to assess two factors in patients with inflammatory bowel disease: a) whether health-related quality of life is independently associated with both bowel disease severity and psychological disorder, and b) whether Crohn's disease is associated with more marked psychological disorder than ulcerative colitis. METHODS: 116/170 (68%) consecutive patients with inflammatory bowel disease attending a GI clinic (37 patients with ulcerative colitis, 75 patients with Crohn's disease, and four unspecified) completed the following self-report questionnaires: demographic details, a modified disease activity index, a total severity measure, the Hospital Anxiety and Depression Scale, and the Short Form-36. RESULTS: Thirty patients (25.9%) scored 11 or more on either the depression or anxiety subscales of the Hospital Anxiety and Depression Scale indicating probable psychological disorder; 55% (47.4%) scored over 8 indicating possible psychological disorder. Stepwise multiple regression analyses showed that both psychological symptoms and disease severity or activity contributed independently to impaired health-related quality of life. After severity of disease was taken into account, there were no significant differences between Crohn's disease and ulcerative colitis in terms of depression scores and health-related quality of life. CONCLUSIONS: The presence of psychological disorder in inflammatory bowel disease contributes to poor health-related quality of life, regardless of the severity of the condition. Detection and treatment of psychological disorder in inflammatory bowel disease carries the potential to improve health-related quality of life for these patients.
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?
Psychological symptoms, perceived stress, and disease severity can have a deleterious effect on HRQOL.
“It has been confirmed that psychological symptoms, perceived stress, and disease severity can have a deleterious effect on HRQOL (103, 104).”
From Stress triggers flare of inflammatory bowel disease in children and adults (2019) · cites this paper as [103]
Cites
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
(1992) · PubMed · Cited by 33,716 · see citing works
The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection
Ware, J. E., & Sherbourne, C. D. (1992) · Medical Care · doi:10.1097/00005650-199206000-00002 · Cited by 30,033 · see citing works
Short form 36 (SF36) health survey questionnaire: normative data for adults of working age.
Jenkinson, C., Coulter, A., & Wright, L. (1993) · BMJ · doi:10.1136/bmj.306.6890.1437 · Cited by 1,714 · see citing works
A New Measure of Health Status for Clinical Trials in Inflammatory Bowel Disease
Guyatt, G., Mitchell, A., Irvine, E. J., Singer, J., Williams, N., Goodacre, R. L., & Tompkins, C. (1989) · Gastroenterology · doi:10.1016/s0016-5085(89)80080-0 · Cited by 1,289 · see citing works
The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS?
Garratt, A., Ruta, D. A., Abdalla, M., Buckingham, J. K., & Russell, I. T. (1993) · BMJ · doi:10.1136/bmj.306.6890.1440 · Cited by 1,142 · see citing works
Anderson, I. M., Ferrier, I. N., Baldwin, R., Cowen, P. J., Howard, L. M., Lewis, G., Matthews, K., McAllister-Williams, H., Peveler, R. C., Scott, J. L., et al. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881107088441 · Cited by 901 · see citing works
Health-related quality of life in inflammatory bowel disease
Drossman, D. A., Patrick, D. L., Mitchell, C. M., Zagami, E. A., & Appelbaum, M. I. (1989) · Digestive Diseases and Sciences · doi:10.1007/bf01538073 · Cited by 404 · see citing works
Psychiatric illness and irritable bowel syndrome: a comparison with inflammatory bowel disease
Walker, E. A., Roy‐Byrne, P., Katon, W. J., Li, L., Amos, D., & Jiranek, G. (1990) · American Journal of Psychiatry · doi:10.1176/ajp.147.12.1656 · Cited by 233 · see citing works
Quality of Life in Patients with Inflammatory Bowel Disease
Mitchell, A., Guyatt, G. H., Singer, J., Irvine, E. J., Goodacre, R. L., Tompkins, C., Williams, N., & Wagner, F. (1988) · Journal of Clinical Gastroenterology · doi:10.1097/00004836-198806000-00014 · Cited by 202 · see citing works
[Quality of life in the patients with inflammatory bowel disease].
Sakurai, T. (2012) · PubMed · Cited by 184 · see citing works
Walker, E. A., Gelfand, A. N., Gelfand, M. D., & Katon, W. J. (1995) · Psychological Medicine · doi:10.1017/s0033291700033225 · Cited by 181 · see citing works
Health status and health care use in persons with inflammatory bowel disease
Drossman, D. A., Leserman, J., Mitchell, C. M., Li, Z., Zagami, E. A., & Patrick, D. L. (1991) · Digestive Diseases and Sciences · doi:10.1007/bf01296620 · Cited by 171 · see citing works
Personality profile and affective state of patients with inflammatory bowel disease.
Robertson, D. A., Ray, J., Diamond, I., & Edwards, J. (1989) · Gut · doi:10.1136/gut.30.5.623 · Cited by 156 · see citing works
van Hemert, A. M., Hengeveld, M. W., Bolk, J. H., Rooijmans, H. G. M., & Vandenbroucke, J. P. (1993) · Psychological Medicine · doi:10.1017/s0033291700038952 · Cited by 154 · see citing works
Do Life Events or Depression Exacerbate Inflammatory Bowel Disease?: A Prospective Study
North, C. S., Alpers, D. H., Helzer, J. E., Spitznagel, E. L., & Clouse, R. E. (1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-114-5-381 · Cited by 152 · see citing works
Walker, E. A., Gelfand, M. D., Gelfand, A. N., Creed, F., & Katon, W. J. (1996) · General Hospital Psychiatry · doi:10.1016/0163-8343(96)00036-9 · Cited by 144 · see citing works
Self-citationPorcell, P., Leoci, C., & Guerra, V. (1996) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365529609010354 · Cited by 139 · see citing works
A controlled study of the association between ulcerative colitis and psychiatric diagnoses
Helzer, J. E., Stillings, W. A., Chammas, S., Norland, C. C., & Alpers, D. (1982) · Digestive Diseases and Sciences · doi:10.1007/bf01296730 · Cited by 125 · see citing works
Turnbull, G. K., & Vallis, M. (1995) · PubMed · Cited by 121 · see citing works
Health status in inflammatory bowel disease
Garrett, J. W., & Drossman, D. A. (1990) · Gastroenterology · doi:10.1016/0016-5085(90)91234-w · Cited by 115 · see citing works
Rüssel, M. G., Pastoor, C. J., Brandon, S., Rijken, J., Engels, L. G. J. B., van der Heijde, D. M. F. M., & Stockbrügger, R. W. (2009) · Digestion · doi:10.1159/000201455 · Cited by 114 · 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
Quality of life assessment by patients with inflammatory bowel disease
Farmer, R. G., Easley, K. A., & Farmer, J. M. (1992) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.59.1.35 · Cited by 99 · see citing works
Provenzale, D., Shearin, M., Phillips-Bute, B., et al. (1997) · Gastroenterology · doi:10.1016/s0016-5085(97)70074-x · Cited by 92 · see citing works
Alexithymia in Inflammatory Bowel Disease
Porcelli, P., Zaka, S., Leoci, C., Centonze, S., & Taylor, G. J. (2010) · Psychotherapy and Psychosomatics · doi:10.1159/000288990 · Cited by 86 · see citing works
Quality of Life–Measurement in Inflammatory Bowel Disease
Irvine, E. J. (1993) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365529309098355 · Cited by 84 · see citing works
Predictors of health care utilization in patients with inflammatory bowel disease
de Boer, A. G. E. M., Sprangers, M. A. G., Bartelsman, J. F. W. M., & de Haes, J. C. J. M. (1998) · European Journal of Gastroenterology & Hepatology · doi:10.1097/00042737-199809000-00010 · Cited by 79 · see citing works
Development of a Crohn's index for survey research
Sandler, R. S., Jordan, M. C., & Kupper, L. L. (1988) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(88)90046-7 · Cited by 74 · see citing works
Psychological distress and levels of disease activity in inflammatory bowel disease.
Porcelli, P., Zaka, S., Centonze, S., & Sisto, G. (1994) · PubMed · Cited by 71 · see citing works
Han, S. (1998) · Scandinavian Journal of Gastroenterology · doi:10.1080/003655298750026994 · Cited by 69 · see citing works
Hjortswang, H., Strom, M., de Almeida, L. M., & Almer, S. H. (1997) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365529709028153 · Cited by 57 · see citing works
Quality of life in inflammatory bowel disease.
Martín, A., Leone, L., Fries, W., & Naccarato, R. (1995) · PubMed · Cited by 49 · see citing works
THE PSYCHOLOGICAL CARE OF MEDICAL PATIENTS - RECOGNITION OF NEED AND SERVICE PROVISION
Dawson, A. J., Creed, F., Hibbs, P., James, J., Keown, J., King, D., Maguire, G. P., Mayou, R., Paykel, F., Sterling, G., et al. (1995) · Journal of the Royal College of Physicians of London · Cited by 40 · see citing works
Self-citationFactors related to dissociation among patients with gastrointestinal complaints
Engel, C. C., Walker, E. A., & Katon, W. J. (1996) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(95)00636-2 · Cited by 27 · see citing works
Guthrie, E., Creed, F. H., & Whorwell, P. J. (1990) · European Journal of Gastroenterology & Hepatology · Cited by 19 · see citing works
Self-citationPersonality, smoking and inflammatory bowel disease.
Barrett, S., Standen, P., Lee, A. S., Hawkey, C. J., & Logan, R. F. (1996) · PubMed · Cited by 17 · see citing works
Central 5-Hydroxytryptaminergic Function in Irritable Bowel Syndrome
Gorard, S. A. C., Dewsnap, P., Medbak, S., Perry, L., Libby, G., & Farthing, M. J. G. (1995) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365529509096344 · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Barberio, B., Zamani, M., Black, C. J., Savarino, E. V., & Ford, A. C. (2021) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(21)00014-5 · Cited by 758 · see citing works
Brain–Gut Interactions in Inflammatory Bowel Disease
Bonaz, B. L., & Bernstein, C. N. (2013) · Gastroenterology · doi:10.1053/j.gastro.2012.10.003 · Cited by 667 · see citing works
Walker, J. R., Ediger, J. P., Graff, L. A., Greenfeld, J. M., Clara, I., Lix, L., Rawsthorne, P., Miller, N., Rogala, L., McPhail, C. M., et al. (2008) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2008.01980.x · Cited by 437 · see citing works
Caprilli, R., Gassull, M. A., Escher, J. C., Moser, G., Munkholm, P., Forbes, A., Hommes, D. W., Lochs, H., Angelucci, E., Cocco, A., et al. (2006) · Gut · doi:10.1136/gut.2005.081950c · Cited by 428 · see citing works
Pain and inflammatory bowel disease.
Bielefeldt, K., Davis, B., & Binion, D. G. (2009) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20848 · Cited by 304 · see citing works
Fuller-Thomson, E., & Sulman, J. (2006) · Inflammatory Bowel Diseases · doi:10.1097/00054725-200608000-00005 · Cited by 292 · see citing works
Graff, L. A., Walker, J. R., Lix, L., Clara, I., Rawsthorne, P., Rogala, L., Miller, N., Jakul, L., McPhail, C., Ediger, J., et al. (2006) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2006.09.027 · Cited by 292 · see citing works
Psychological issues in inflammatory bowel disease: an overview
Sajadinejad, M. S., Asgari, K., Molavi, H., Kalantari, M., & Adibi, P. (2012) · Gastroenterology Research and Practice · doi:10.1155/2012/106502 · Cited by 242 · see citing works
Lix, L. M., Graff, L. A., Walker, J. R., Clara, I., Rawsthorne, P., Rogala, L., Miller, N., Ediger, J., Pretorius, T., & Bernstein, C. N. (2008) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20511 · Cited by 238 · see citing works
Prevalence of anxiety and depression in patients with inflammatory bowel disease
Byrne, G., Rosenfeld, G., Leung, Y., Qian, H., Raudzus, J., Nunez, C., & Bressler, B. (2017) · Canadian Journal of Gastroenterology and Hepatology · doi:10.1155/2017/6496727 · Cited by 234 · see citing works
Romberg-Camps, M. J. L., Bol, Y., Dagnelie, P. C., Hesselink-van de Kruijs, M. A. M., Kester, A. D. M., Engels, L. G. J. B., van Deursen, C., Hameeteman, W. H. A., Pierik, M., Wolters, F., et al. (2010) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21285 · Cited by 240 · see citing works
PERSOONS, P., VERMEIRE, S., DEMYTTENAERE, K., FISCHLER, B., VANDENBERGHE, J., VAN OUDENHOVE, L., PIERIK, M., HLAVATY, T., VAN ASSCHE, G., NOMAN, M., et al. (2005) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2005.02535.x · Cited by 253 · see citing works
Mikocka-Walus, A. A., Turnbull, D. A., Moulding, N. T., Wilson, I. G., Andrews, J. M., & Holtmann, G. J. (2007) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20062 · Cited by 178 · see citing works
Stress triggers flare of inflammatory bowel disease in children and adults
Sun, Y., Li, L., Xie, R., Wang, B., Jiang, K., & Cao, H. (2019) · Frontiers in Pediatrics · doi:10.3389/fped.2019.00432 · Cited by 171 · see citing works
Kiebles, J. L., Doerfler, B., & Keefer, L. (2010) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21215 · Cited by 132 · see citing works
Bennebroek Evertsz', F., Thijssens, N. A. M., Stokkers, P. C. F., Grootenhuis, M. A., Bockting, C. L. H., Nieuwkerk, P. T., & Sprangers, M. A. G. (2012) · Journal of Crohn's and Colitis · doi:10.1016/j.crohns.2011.07.006 · Cited by 131 · see citing works
Psychiatric co‐morbidity is associated with increased risk of surgery in Crohn's disease
Ananthakrishnan, A. N., Gainer, V. S., Perez, R. G., Cai, T., Cheng, S. ‐., Savova, G., Chen, P., Szolovits, P., Xia, Z., De Jager, P. L., et al. (2013) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12195 · Cited by 122 · see citing works
Larsson, K., Lööf, L., Rönnblom, A., & Nordin, K. (2008) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2007.10.007 · Cited by 115 · see citing works
Lewis, K., Marrie, R. A., Bernstein, C. N., Graff, L. A., Patten, S. B., Sareen, J., Fisk, J. D., Bolton, J. M., CIHR Team in Defining the Burden and Managing the Effects of Immune-Mediated Inflammatory Disease, Marrie, R. A., et al. (2019) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izz045 · Cited by 115 · 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
Psychotherapy with chronic inflammatory bowel disease patients: A Review
von Wietersheim, J., & Kessler, H. (2006) · Inflammatory Bowel Diseases · doi:10.1097/01.mib.0000236925.87502.e0 · Cited by 103 · see citing works
Moreno-Jiménez, B., López Blanco, B., Rodríguez-Muñoz, A., & Garrosa Hernández, E. (2007) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2006.07.026 · Cited by 89 · see citing works
Gray, W. N., Denson, L. A., Baldassano, R. N., & Hommel, K. A. (2011) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21520 · Cited by 86 · see citing works
Neilson, K., Ftanou, M., Monshat, K., Salzberg, M., Bell, S., Kamm, M. A., Connell, W., Knowles, S. R., Sevar, K., Mancuso, S. G., et al. (2016) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000000629 · Cited by 80 · see citing works
Alexakis, C., Kumar, S., Saxena, S., & Pollok, R. (2017) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.14171 · Cited by 69 · see citing works
Bhandari, S., Larson, M. E., Kumar, N., & Stein, D. (2017) · Gut and Liver · doi:10.5009/gnl16347 · Cited by 66 · see citing works
Inflammatory bowel disease and completed suicide in Danish adults
Gradus, J. L., Qin, P., Lincoln, A. K., Miller, M., Lawler, E., Srensen, H. T., & Lash, T. L. (2010) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21298 · Cited by 62 · see citing works
Repeated predictable stress causes resilience against colitis-induced behavioral changes in mice
Hassan, A. M., Jain, P., Reichmann, F., Mayerhofer, R., Farzi, A., Schuligoi, R., & Holzer, P. (2014) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2014.00386 · Cited by 59 · see citing works
The burden of comedication among patients with inflammatory bowel disease
Buckley, J. P., Kappelman, M. D., Allen, J. K., Van Meter, S. A., & Cook, S. F. (2013) · Inflammatory Bowel Diseases · doi:10.1097/01.mib.0000435442.07237.a4 · Cited by 59 · see citing works
Thavamani, A., Umapathi, K. K., Khatana, J., & Gulati, R. (2019) · Pediatric Gastroenterology, Hepatology & Nutrition · doi:10.5223/pghn.2019.22.6.527 · Cited by 54 · see citing works
Anxiety but not depression predicts poor outcomes in inflammatory bowel disease
Narula, N., Pinto-Sanchez, M. I., Calo, N. C., Ford, A. C., Bercik, P., Reinisch, W., & Moayyedi, P. (2019) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izy385 · Cited by 52 · see citing works
Gotthardt, D. N., Rupp, C., Bruhin, M., Schellberg, D., Weiss, K. H., Stefan, R., Donnerstag, N., Stremmel, W., Löwe, B., Juenger, J., et al. (2014) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000000223 · Cited by 41 · see citing works
Van Langenberg, D. R., Lange, K., Hetzel, D. J., Holtmann, G. J., & Andrews, J. M. (2010) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2010.06302.x · Cited by 40 · see citing works
Trindade, I. A., Ferreira, C., & Pinto-Gouveia, J. (2016) · Journal of Health Psychology · doi:10.1177/1359105315587142 · Cited by 33 · see citing works
Psychological mediators of psychological distress and quality of life in inflammatory bowel disease
Kantidakis, J. D., Moulding, R., & Knowles, S. R. (2021) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2021.110596 · Cited by 26 · see citing works
An 18-month study of the effects of IBD symptomatology and emotion regulation on depressed mood
Trindade, I. A., Ferreira, C., Moura-Ramos, M., & Pinto-Gouveia, J. (2017) · International Journal of Colorectal Disease · doi:10.1007/s00384-017-2774-z · Cited by 20 · see citing works
Stone, J. K., Shafer, L. A., Graff, L. A., Witges, K., Sexton, K., Lix, L. M., Haviva, C., Targownik, L. E., & Bernstein, C. N. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.110719 · Cited by 18 · see citing works
Ling, F., Tu, L., Li, J., Chen, Y., Xu, M., & Zhu, L. (2021) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365521.2021.1966093 · Cited by 10 · see citing works
- Authors
- Guthrie, E., Jackson, J., Shaffer, J., Thompson, D., Tomenson, B., & Creed, F.
- Affiliations
- University of Manchester (GB)
- Venue
- The American Journal of Gastroenterology
- Published
- 2002-08
- Volume
- 97
- Issue
- 8
- Pages
- 1994-1999
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- OpenAlex
- W2047891804
- Cited by
- 306
- References
- 38
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 7 · 2023: 10 · 2022: 12 · 2021: 15 · 2020: 13 · 2019: 18 · 2018: 17 · 2017: 14 · 2016: 9 · 2015: 14 · 2014: 15 · 2013: 17 · 2012: 12
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- inflammatory bowel disease, ulcerative colitis, Crohn's disease, health-related quality of life, mental illness, depression, anxiety, disease severity, disease activity, Hospital Anxiety and Depression Scale, Short Form-36
- MeSH terms
- Adult, Anxiety, Colitis, Ulcerative, Crohn Disease, Depression, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Quality of Life, Severity of Illness Index, Chi-Square Distribution
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
