Stressful Life Events as a Risk Factor for Inflammatory Bowel Disease Onset: A Population-Based Case–Control Study
Abstract
BACKGROUND AND AIMS: Stress is often perceived by patients with inflammatory bowel disease (IBD) as the leading cause of their disease. The aim of this study was to assess whether stress, evaluated through life event (LE) occurrence, is associated with IBD onset. METHODS: Incident cases of IBD, including 167 patients with Crohn's disease (CD) and 74 with ulcerative colitis (UC), were compared with two control groups, one of 69 patients with acute self-limited colitis (ASLC) and another of 255 blood donors (BDs). Stress was assessed using Paykel's self-questionnaire of LEs. Only LEs occurring within 6 months before the onset of symptoms in IBD cases and ASLC controls and before blood donation in BD controls were registered. Anxiety and depression were assessed using Bate's and Beck's questionnaires, respectively. RESULTS: In univariate analysis, occurrence of LEs was more frequent in the 6-month period prior to diagnosis in CD cases than in UC cases or either control group. After adjustment for depression and anxiety scores as well as other characteristics such as smoking status and sociodemographic features, this association appeared no longer significant. No associations were noted between occurrence of LEs and onset of UC relative to controls. CONCLUSIONS: Despite its separate association with CD, LE occurrence does not appear to be an independent risk factor for IBD onset.
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Nine of 13 studies found significantly higher rates and/or levels of depression in IBD participants than in healthy controls.
“Nine found significantly higher rates and/or levels of depression in IBD participants than in healthy controls (n=3,517 IBD; n=12,212 controls) (9, 15, 16, 19-22, 24, 26).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [21]
Of 17 studies assessing depression, 10 showed statistically significant differences between IBD and other medically ill cohorts.
“Of the 17 studies assessing depression, 10 showed statistically significant differences between IBD and other medically ill cohorts (17, 21, 67, 68, 70, 71, 73-75, 77).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [21]
Five studies indicated higher rates or levels of depression in IBD than in participants with self-limited colitis, colorectal cancer, juvenile idiopathic arthritis, and several other conditions (coeliac disease, food allergy, GERD, congenital disorders).
“five (n=648 IBD and 601 controls) (17, 21, 68, 70, 71) indicated higher rates or levels in IBD than in participants with self-limited colitis, colorectal cancer, juvenile idiopathic arthritis, and several other conditions (coeliac disease, food allergy, GERD, congenital disorders).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [21]
Of 28 studies, 21 measured anxiety, and only three concluded statistically significant differences between IBD subtypes, all indicating higher anxiety for CD.
“Twenty-one of the 28 studies measured anxiety, with only three of them concluding there were statistically significant differences between IBD subtypes, all of which indicated higher anxiety for those with CD (21, 29, 41).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [21]
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- Authors
- Lerebours, E., Gower-Rousseau, C., Merle, V., Brazier, F., Debeugny, S., Marti, R., Salomez, J. L., Hellot, M. F., Dupas, J. L., Colombel, J. F., Cortot, A., & Benichou, J.
- Affiliations
- Centre Hospitalier Universitaire de Rouen (FR)
- Centre Hospitalier Universitaire Amiens-Picardie (FR)
- Centre Hospitalier Universitaire de Lille (FR)
- Venue
- The American Journal of Gastroenterology
- Published
- 2007-01
- Volume
- 102
- Issue
- 1
- Pages
- 122-131
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- OpenAlex
- W2072004231
- Cited by
- 130
- References
- 4
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 4 · 2022: 4 · 2021: 11 · 2020: 8 · 2019: 3 · 2018: 3 · 2017: 10 · 2016: 10 · 2015: 6 · 2014: 6 · 2013: 15 · 2012: 10
- FWCI
- 3.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- 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
- inflammatory bowel disease, life events, Crohn's disease, ulcerative colitis, disease onset, risk factors, anxiety, depression, psychological stress
- MeSH terms
- Adult, Female, Humans, Life Change Events, Male, Surveys and Questionnaires, Risk Factors, Stress, Psychological, Inflammatory Bowel Diseases, Chi-Square Distribution, Case-Control Studies
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