CoChat
Sign Up
Cited by 31Inflammatory Bowel DiseaseOcular Diseases and Behçet’s SyndromeMicroscopic Colitis

Life-event stress induced by the Great East Japan Earthquake was associated with relapse in ulcerative colitis but not Crohn’s disease: A retrospective cohort study

Open access
Shiga, Hisashi, Miyazawa, Teruko, Kinouchi, Yoshitaka, Takahashi, Seiichi, Tominaga, Gen, Takahashi, Hiroki, Takagi, Sho, Obana, Nobuya +15 more·2013·BMJ Open
DOI 10.1136/bmjopen-2012-002294PMC PMC3586105
Open this paper in CoChat — free accountOpen PDF

Abstract

OBJECTIVE: Stress is thought to be one of the triggers of relapses in patients with inflammatory bowel disease (IBD). We examined the rate of relapse in IBD patients before and after the Great East Japan Earthquake. DESIGN: A retrospective cohort study. SETTINGS: 13 hospitals in Japan. PARTICIPANTS: 546 ulcerative colitis (UC) and 357 Crohn's disease (CD) patients who received outpatient and inpatient care at 13 hospitals located in the area that were seriously damaged by the earthquake. Data on patient's clinical characteristics, disease activity and deleterious effects of the earthquake were obtained from questionnaires and hospital records. PRIMARY OUTCOME: We evaluated the relapse rate (from inactive to active) across two consecutive months before and two consecutive months after the earthquake. In this study, we defined 'active' as conditions with a partial Mayo score=2 or more (UC) or a Harvey-Bradshaw index=6 or more (CD). RESULTS: Among the UC patients, disease was active in 167 patients and inactive in 379 patients before the earthquake. After the earthquake, the activity scores increased significantly (p<0.0001). A total of 86 patients relapsed (relapse rate=15.8%). The relapse rate was about twice that of the corresponding period in the previous year. Among the CD patients, 86 patients had active disease and 271 had inactive disease before the earthquake. After the earthquake, the activity indices changed little. A total of 25 patients experienced a relapse (relapse rate=7%). The relapse rate did not differ from that of the corresponding period in the previous year. Multivariate analyses revealed that UC, changes in dietary oral intake and anxiety about family finances were associated with the relapse. CONCLUSIONS: Life-event stress induced by the Great East Japan Earthquake was associated with relapse in UC but not CD.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/bmjopen-2012-002294

Cites

29 of 29 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

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?

  • Stress is associated with disease activity and severity in IBD.

    “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].”

    From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [15]

    The Discussion reports that earthquake-related psychological stress was associated with relapse in ulcerative colitis, but not Crohn’s disease. This supports an association with disease activity in one form of IBD, not the broader claim across IBD or a separate association with disease severity. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Comorbid psychological difficulties in IBD are associated with disease activity, flares, treatment response, and the necessity of surgical intervention.

    “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].”

    From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [15]

    The Discussion (page not specified) links psychological stress to relapse in ulcerative colitis, but reports no such association for Crohn’s disease. The Results (page not specified) show increased ulcerative-colitis activity after the earthquake. The paper does not establish an association with treatment response or the need for surgery. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Shiga, H., Miyazawa, T., Kinouchi, Y., Takahashi, S., Tominaga, G., Takahashi, H., Takagi, S., Obana, N., Kikuchi, T., Oomori, S., Nomura, E., Shiraki, M., Sato, Y., Takahashi, S., Umemura, K., Yokoyama, H., Endo, K., Kakuta, Y., Aizawa, H., Matsuura, M., Kimura, T., Kuroha, M., & Shimosegawa, T.
Affiliations
  • Tohoku University (JP)
  • Japanese Red Cross Ishinomaki Hospital (JP)
  • Sendai Medical Center (JP)
  • Takagi Clinic, Sendai, Japan
  • Osaki Citizen Hospital (JP)
  • Sendai City Hospital (JP)
  • Sendai Red Cross Hospital (JP)
  • Miyagi Prefectural Hospital Organization (JP)
  • Iwate Prefectural Isawa Hospital (JP)
  • South Miyagi Medical Center (JP)
  • Iwate Prefectural Iwai Hospital (JP)
  • Department of Internal Medicine, Kesennuma City Hospital, Kesennuma, Japan
Corresponding author
Shiga, Hisashi
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2013
Volume
3
Issue
2
Pages
e002294
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2012-002294
PMC
PMC3586105
OpenAlex
W2103435003
Cited by
31
References
29
Citations by year
2025: 1 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 2 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 8 · 2014: 2 · 2013: 1
FWCI
2.87
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
Japan Society for the Promotion of Science (24790725)
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, Crohn's disease, inflammatory bowel disease, recurrence, life events, Great East Japan Earthquake, natural disasters, psychological stress, dietary intake, disease activity

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