Cited by 226Inflammatory Bowel DiseaseOcular Diseases and Behçet’s SyndromePsychosomatic Disorders and Their Treatments

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Psychosocial Determinants of Relapse in Ulcerative Colitis: A Longitudinal Study

Bitton, Alain, Sewitch, Maida J, Peppercorn, Mark A, de B Edwardes, Michael D, Shah, Samir, Ransil, Bernard, Locke, Steven E·2003·American Journal of Gastroenterology

DOI 10.1111/j.1572-0241.2003.07717.x

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Abstract

OBJECTIVES: To determine the association between psychosocial characteristics and time to relapse in patients with inactive ulcerative colitis. METHODS: Sixty patients with clinically and endoscopically inactive ulcerative colitis were followed for 1 yr, or less if they relapsed. Demographic, psychosocial, and clinical data were obtained. Stressful life events (Psychiatric Epidemiology Research Interview Life Events Scale), psychological distress (Symptom Checklist-90R), and perceived stress (Perceived Stress Scale) were recorded monthly by self-report. Multivariate time-dependent Cox regression was used to identify the independent determinants of earlier time to clinical relapse. RESULTS: The patients' mean age was 39 yr (SD = 9.4), 37 (62%) were female, and 22 (37%) relapsed during the 1-yr follow-up. Univariate Cox regression indicated a weak association between number of stressful events in the preceding month and time to relapse (p = 0.09). This association strengthened in multivariate analysis (p = 0.02, hazard ratio = 1.26 per event, 95% CI = 1.04-1.53) after adjustment for significant covariates. CONCLUSIONS: After controlling for demographic and clinical variables, more recent stressful events were associated with earlier time to relapse. These findings, which support a biopsychosocial model of disease, might help clinicians identify patients who might benefit from more intensive maintenance medical therapy and behavioral medicine interventions to reduce stress and improve coping.

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Authors: Bitton, A., Sewitch, M. J., Peppercorn, M. A., de B Edwardes, M. D., Shah, S., Ransil, B., & Locke, S. E.
Affiliations: McGill University (CA)
Université de Montréal (CA)
Beth Israel Deaconess Medical Center (US)
Harvard University (US)
Corresponding author: Bitton, Alain
ORCID: Bitton, Alain
Sewitch, Maida J
Venue: American Journal of Gastroenterology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2003-10
Volume: 98
Issue: 10
Pages: 2203-2208
ISSN: 0002-9270 (ISSN-L)
DOI: 10.1111/j.1572-0241.2003.07717.x
OpenAlex: W2092717271
Cited by: 226
References: 26
Citations by year: 2026: 4 · 2025: 2 · 2024: 12 · 2023: 4 · 2022: 14 · 2021: 10 · 2020: 9 · 2019: 12 · 2018: 17 · 2017: 7 · 2016: 5 · 2015: 11 · 2014: 7 · 2013: 9 · 2012: 14
FWCI: 5.13
Type: journal article
Language: en
Open access: closed
Locations: The American Journal of Gastroenterology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r24mh056217-05)
National Institute of Mental Health (MH-56217)
Topics: Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords: ulcerative colitis, relapse, psychosocial factors, life events, psychological distress, perceived stress, time to relapse, biopsychosocial model, maintenance therapy, behavioral medicine, coping
MeSH terms: Adult, Colitis, Ulcerative, Female, Humans, Longitudinal Studies, Male, Middle Aged, Probability, Prognosis, Prospective Studies, Psychology, Recurrence, Risk Factors, Severity of Illness Index, Stress, Psychological, Incidence, Multivariate Analysis, Proportional Hazards Models, Age Distribution, Sex Distribution

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Psychosocial Determinants of Relapse in Ulcerative Colitis: A Longitudinal Study

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