The DOI matches its Crossref record; 63 of the 63 references it cites were found in a registry or an index.
Predicting relapse in Crohn’s disease: a biopsychosocial model
Abstract
Background: Crohn’s disease (CD) is a chronic relapsing inflammatory bowel disorder. Both biological and psychosocial factors may modulate the illness experience. Aim: The aim of this study was to identify clinical, biological and psychosocial parameters as predictors of clinical relapse in quiescent CD. Methods: Patients in medically induced remission were followed prospectively for 1 year, or less if they relapsed. Disease characteristics were determined at baseline. Serum cytokines, anti- Saccharomyces cerevisiae antibodies, C-reactive protein (CRP), erythrocyte sedimentation rate and intestinal permeability were measured every 3 months. Psychological distress, perceived stress, minor life stressors and coping strategies were measured monthly. A time-dependent multivariate Cox regression model determined predictors of time to relapse. Results: 101 patients (60 females, 41 males) were recruited. Fourteen withdrew and 37 relapsed. CRP (HR = 1.5 per 10 mg/l, 95% CI 1.1 to 1.9, p = 0.007), fistulising disease (HR = 3.2, 95% CI, 1.1 to 9.4, p = 0.04), colitis (HR = 3.5 95% CI 1.2 to 9.9, p = 0.02) and the interaction between perceived stress and avoidance coping (HR = 7.0 per 5 unit increase for both scales, 95% CI 2.3 to 21.8, p = 0.003) were predictors of earlier relapse. Conclusions: In quiescent CD, a higher CRP, fistulising disease behaviour and disease confined to the colon were independent predictors of relapse. Moreover, patients under conditions of low stress and who scored low on avoidance coping (ie, did not engage in social diversion or distraction) were least likely to relapse. This study supports a biopsychosocial model of CD exacerbation.
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“When we restricted the analysis to include only the two studies that recruited patients in clinical remission,[20, 26] the risk of flare among those with symptoms of anxiety at baseline was significantly higher (RR = 1.80; 95% CI 1.242.61).”
From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [20]
In the citing paper
“The 13 eligible articles reported on 12 separate study populations,[11, 20-30, 33] containing 9192 patients.”
From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [20]
In the citing paper
“Study quality is provided in Supplementary Tables 1 and 2; five studies scored 7 or more on the NewcastleOttawa scale.[11, 20, 23, 24, 26]”
From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [20]
In the citing paper
“When data were pooled from five studies,[20, 26, 27, 29, 30] containing 1244 patients, the risk of developing a flare of disease activity was no higher among those with symptoms of anxiety at baseline (RR = 1.20; 95% CI 0.93-1.55), with moderate heterogeneity between studies ( I 2 =53.7%).”
From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [20]
In the citing paper
“When data were pooled from eight studies,[20-23, 26, 27, 29, 30] which included 7606 patients, symptoms of depression at baseline were associated with a significantly increased risk of flare of disease activity during longitudinal follow-up (RR = 1.60; 95% CI 1.212.12), with high heterogeneity between studies ( I 2 =73.5%)”
From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [20]
In the citing paper
“However, when the analysis was restricted to include only three studies that recruited only patients in clinical remission,[20, 23, 26] there was no longer a significant increase in risk (RR = 1.36; 95% CI 0.88-2.09).”
From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [20]
Citations
Cites
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807
The Need for a New Medical Model: A Challenge for Biomedicine
Engel, G. L. (1977) · Science · doi:10.1126/science.847460 · Cited by 12,887
(1988) · Cited by 4,111
Folkman, S., & Moskowitz, J. T. (2004) · Annual Review of Psychology · doi:10.1146/annurev.psych.55.090902.141456 · Cited by 3,485
Development of a Crohn's Disease Activity Index
Best, W. R., Becktel, J. M., Singleton, J. W., & Kern, F. (1976) · Gastroenterology · doi:10.1016/s0016-5085(76)80163-1 · Cited by 3,152
Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study.
Best, W. R., Becktel, J. M., Singleton, J. W., & Kern, F. (1976) · PubMed · Cited by 3,147
Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events
Kanner, A. D., Coyne, J. C., Schaefer, C. A., & Lazarus, R. S. (1981) · Journal of Behavioral Medicine · doi:10.1007/bf00844845 · Cited by 3,128
Loftus, E. V. (2004) · Gastroenterology · doi:10.1053/j.gastro.2004.01.063 · Cited by 3,106
Stress-induced immune dysfunction: implications for health
Glaser, R., & Kiecolt-Glaser, J. K. (2005) · Nature Reviews Immunology · doi:10.1038/nri1571 · Cited by 2,190
Classification of Inflammatory Bowel Disease
Lennard‐Jones, J. E. (1989) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528909091339 · Cited by 2,022
Flagged first, then by citations
Cited by
Sorted by citations
Items 201–254 of 254
Langhorst, J., & Lauche, R. (2014) · Digestion · doi:10.1159/000357368 · Cited by 4
A review of the link between psychological stress and inflammatory bowel disease exacerbation
Klettner, A. M., Luo, S., Coyle, L. D., & Liu, N. (2025) · Academia Mental Health and Well-Being · doi:10.20935/mhealthwellb7617 · Cited by 3
Pathogenesis of Inflammatory Bowel Disease
Dolu, S. (2025) · Journal of Enterocolitis · doi:10.14744/jenterocolitis.2025.15570 · Cited by 3
C-Reactive Protein in Inflammatory Bowel Disease
Malakar, S. (2020) · Springer eBooks · doi:10.1007/978-981-15-6787-2_3 · Cited by 3
Artru-Voegelé, S., Sinniger, V., Batandier, C., Troprés, I., Sonia Pellissier, A., & Bonaz, B. L. (2022) · HEGEL - HEpato-GastroEntérologie Libérale · doi:10.3917/heg.123.0199 · Cited by 3
Egészséggel kapcsolatos célok Crohn-betegek körében.
Festő, B., Njers, S., Dávid, A., Horvát, B., Sallay, V., Molnár, T., Rafael, B., & Martos, T. (2023) · Orvosi Hetilap · doi:10.1556/650.2023.32801 · Cited by 3
Psychological Stress and the Kaleidoscope of Autoimmune Diseases
Sharif, Κ., Watad, ., Krosser, A., Coplan, L., Amital, H., Afek, A. B., & Shoenfeld, Y. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-814307-0.00033-5 · Cited by 3
Snyder, E. F., Davis, S. C., Aldrich, K., Veerabagu, M., Larussa, T., Abenavoli, L., & Boccuto, L. (2021) · The Nurse Practitioner · doi:10.1097/01.npr.0000798212.61425.4f · Cited by 3
Facteurs psychosociaux et risque de rechute au cours de la maladie de Crohn
Lainé, A., Laurent, A., Mariage, A., Boschetti, G., Charlois, A.-L., Roblin, X., Bommelaer, G., Nancey, S., & Flourié, B. (2015) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2015.03.030 · Cited by 3
Cámara, R. J. A., Begré, S., & von Känel, R. (2010) · Journal of Epidemiology · doi:10.2188/jea.je20100087 · Cited by 3
Maser, E. A., & Patel, A. A. (2016) · Springer eBooks · doi:10.1007/978-3-319-43827-6_12 · Cited by 3
Sonia Pellissier, A., Dantzer, C., Canini, F., Mathieu, N., & Bonaz, B. L. (2010) · The American Journal of Gastroenterology · doi:10.1038/ajg.2009.763 · Cited by 3
El-Senosy, F. M., Mohamed, A., Mohamed, A., & Shahin, R. S. (2020) · Al-Azhar Assiut Medical Journal · doi:10.4103/azmj.azmj_170_19 · Cited by 2
Berthold, M.-L., Hartmann, H., Farrher, E., Zimmermann, M., Jaeger, J. W., Shah, N. J., Schneider, K. M., Neuner, I., & Rajkumar, R. (2025) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2025.1620488 · Cited by 2
Liu, Y., Hu, Y., Zheng, J., & Wu, Z. (2026) · Journal of Inflammation Research · doi:10.2147/jir.s594782 · Cited by 2
Awad, C., Maser, E. A., & Patel, A. A. (2024) · Springer eBooks · doi:10.1007/978-3-031-54281-7_32 · Cited by 2
Suskind, D. L., do Vale, E. P. B. M., Kawamura, J., Francis, K. L., Wahbeh, G. T., Lee, D. Y., Musburger, B., Zheng, H. B., & Schwartz, N. R. M. (2025) · JPGN Reports · doi:10.1002/jpr3.70064 · Cited by 1
Bu, S., Chen, M., Li, J., Zhang, T., & Yu, Y. (2026) · Clinical and Experimental Medicine · doi:10.1007/s10238-026-02044-3 · Cited by 1
Complementary and alternative therapies in Crohn's disease and ulcerative colitis
Hawthorne, A. (2010) · Gastrointestinal Nursing · doi:10.12968/gasn.2010.8.3.47653 · Cited by 1
Rahimi, S., Vahedi, H., Gachkar, L., Mojtahedi, S. H., & Seyfollahi, M. (2016) · Alborz University Medical Journal · doi:10.18869/acadpub.aums.5.2.67 · Cited by 1
Duarte, M. J. D. D., de Roda, A. B. L., Astray, A. A., & Diaferia, L. B. (2012) · Hispana · Cited by 1
Ghose, S. M. (2018) · EngagedScholarship @ Cleveland State University (Cleveland State University) · Cited by 1
Morbus Crohn und Psychosomatik
Moser, G. (2010) · Journal für Kardiologie (Krause & Pachernegg GmbH) · Cited by 1
Inflammatory markers for evaluation of inflammatory bowel disease therapy
Lönnkvist, M. H. (2011) · Figshare · Cited by 1
Walsh, S. M. (2014) · Maynooth University ePrints and eTheses Archive (Maynooth University) · Cited by 1
Clinical Features and Diagnosis of Crohn's Disease
Ananthakrishnan, A. N., Xavier, R. J., & Podolsky, D. K. (2017) · Inflammatory Bowel Diseases · doi:10.1002/9781119077633.ch2 · Cited by 2
Sinha, C. K., & Coran, A. G. (2010) · Springer eBooks · doi:10.1007/978-1-84882-132-3_28
Biomarcadores na Doença Inflamatória Intestinal
da Silva, M. M. (2013) · Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) · doi:10.34626/2bsv-yn56
Does hypnotherapy have a role in managing inflammatory bowel disease?
Wahed, M., & Emmanuel, A. V. (2010) · Gastrointestinal Nursing · doi:10.12968/gasn.2010.8.4.48077
How should we follow the Crohn’s disease patients in remission?
Yönal, O., & KAYMAKOĞLU, S. (2010) · The Turkish Journal of Gastroenterology · doi:10.4318/tjg.2010.0064
Japar, S. (2012) · Griffith Research Online · doi:10.25904/1912/3428
Medication management in pediatric chronic illness: Should patient anxiety be considered?
Hoogendoorn, C. J. (2016) · CUNY Academic Works (City University of New York)
The Impact of Stress and Inflammatory Processes on Cognitive Change in Late Adulthood
Balasubramanian, A. B. (2010) · eScholarship (California Digital Library)
Gracie, D. J. (2018) · White Rose eTheses Online (University of Leeds, The University of Sheffield, University of York)
The Role of Biomarkers in Treatment Algorithms for Ulcerative Colitis ( UC )
Khanna, R., & Feagan, B. G. (2019) · Wiley eBooks · doi:10.1002/9781119289234.ch2
Baseline C-Reactive Protein is Associated With Disease Progression in Patients with Crohnʼs Disease
Colombel, J., Sandborn, W. J., Castillo, M., Huang, B., Zhou, Q., & Thakkar, R. B. (2011) · The American Journal of Gastroenterology · doi:10.14309/00000434-201110002-01164
Lainé, A., Laurent, A., Nancey, S., & Flourié, B. (2021) · Pratiques Psychologiques · doi:10.1016/j.prps.2021.04.003
Mind-Body Medicine in Children and Adolescents
McClafferty, H. H. (2017) · MDPI eBooks · doi:10.3390/books978-3-03842-529-8
(2016) · Elsevier eBooks · doi:10.1016/b978-3-437-21833-0.16001-2
Gastrointestinale Erkrankungen
Kapfhammer, H. (2022) · Springer eBooks · doi:10.1007/978-3-662-65873-4_6
Integrative Health Therapies for Pediatric IBD
Vellanki, S., Panganiban, J. A., Erlichman, J., & Mascarenhas, M. R. (2023) · Springer eBooks · doi:10.1007/978-3-031-14744-9_38
Rudravaram, G., Bao, S., Krishnan, A. R., Remedios, L. W., Kim, M. E., Saunders, A. M., Liu, Q., Lau, K. S., Roland, J. T., Washington, M. K., et al. (2025) · SPIE Medical Imaging: Digital and Computational Pathology · doi:10.1117/12.3047121
The War in Gaza and Barriers to Inflammatory Bowel Disease Care
Elimeleh, Y., Ben‐Bassat, O., Benzvi, A., & Zittan, E. (2025) · JGH Open · doi:10.1002/jgh3.70184
Vellanki, S., Holbein, C. E., Boateng, A., Pressman, N., Kirsch, J., Sibinga, E. M. S., Mascarenhas, M., & Albenberg, L. G. (2025) · Global Advances in Integrative Medicine and Health · doi:10.1177/27536130251393662
Systèmes colloïdaux lipidiques pour l’administration par voie orale
Girardon, M. (2019) · theses.fr (ABES) · doi:10.70675/11348879zfce9z4eefz8bc6zcba7dd4093cf
Napolitano, D., Bozzetti, M., Cascio, A. L., Longobucco, Y., Magi, C. E., Iovino, P., & Vellone, E. (2026) · Psychiatric Quarterly · doi:10.1007/s11126-026-10290-7 · Cited by 1
Вячеславовна, Г. А., Haque, A., Reid, N., Inozemtsev, A., Askarova, S., Umriukhin, A., Obleukhova, A., Elena, Z., de Munter, J., Dudchenko, A. M., et al. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27209092
Metadata
- Authors
- Bitton, A., Dobkin, P. L., Edwardes, M. D., Sewitch, M. J., Meddings, J. B., Rawal, S., Cohen, A., Vermeire, S., Dufresne, L., Franchimont, D., & Wild, G. E.
- Affiliations
- McGill University Health Centre (CA)
- University of Alberta (CA)
- Jewish General Hospital (CA)
- Universitair Ziekenhuis Leuven (BE)
- Douglas Mental Health University Institute (CA)
- Corresponding author
- Bitton, A
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2008-04-07
- Volume
- 57
- Issue
- 10
- Pages
- 1386-1392
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- OpenAlex
- W2028756447
- Cited by
- 254
- References
- 63
- Citations by year
- 2026: 4 · 2025: 14 · 2024: 13 · 2023: 6 · 2022: 18 · 2021: 15 · 2020: 10 · 2019: 14 · 2018: 11 · 2017: 20 · 2016: 17 · 2015: 14 · 2014: 15 · 2013: 21 · 2012: 12
- FWCI
- 9.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gut (publishedVersion)
- PubMed (publishedVersion)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Health Sciences › Medicine › Rheumatology › Spondyloarthritis Studies and Treatments
- Keywords
- Crohn's disease, recurrence prediction, biopsychosocial model, C-reactive protein, perceived stress, avoidance coping, colitis, serum cytokines, ASCA, intestinal permeability, psychosocial factors
- MeSH terms
- Adult, Blood Sedimentation, C-Reactive Protein, Crohn Disease, Female, Humans, Male, Models, Psychological, Permeability, Predictive Value of Tests, Prospective Studies, Recurrence, Stress, Psychological, Disease Progression
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