The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index.
Psychosocial Determinants of Relapse in Ulcerative Colitis: A Longitudinal Study
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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“Growing evidence suggests that stress—in particular—is associated with disease activity and severity while conflicting evidence suggests that stress may also be involved in the initial development of IBD [9,15].”
In the citing paper
“Indeed, comorbid psychological difficulties are associated with disease activity, flares, treatment response, and the necessity of surgical intervention [2,6,8,9,10,11,12,13,14,15].”
In the citing paper
“The ACT intervention protocol was developed by the first and last authors and was informed by previous research employing ACT for IBD and single-session ACT interventions [9,34,35,37,70].”
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Metadata
- 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
- Venue
- American Journal of Gastroenterology
- Published
- 2003-10
- Volume
- 98
- Issue
- 10
- Pages
- 2203-2208
- ISSN
- 0002-9270 (ISSN-L)
- 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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