Imbalance in the Stress-Adaptation System in Patients With Inflammatory Bowel Disease
Abstract
Aim: Though inflammatory bowel disease (IBD) is known as a stress-related disorder, basic evidence for this claim is lacking. The current study was performed to investigate the function of the neuroendocrine-immune system as a main pathway in stress response and stress-coping ability and the associations among stress response, stress-coping ability, and disease activity in IBD patients. Method: A questionnaire was administered to obtain information concerning stress state and stress-coping ability (self-efficacy and sense of coherence [SOC]) in 78 IBD patients and 21 healthy volunteers. Blood samples were taken for determining the serum levels of various stress-related hormones and cytokines before and after a calculation stress test. Results: Self-efficacy was significantly decreased in patients, though the degree of perceived stress and SOC did not differ between patients and controls. Basal levels of cortisol did not differ, but levels of adrenocorticotropic hormone, β-endorphin and interleukin (IL)-6 were significantly higher in patients than in controls. In addition, the control group, but not the patient group, demonstrated significant differences in the basal cortisol levels between low and high SOC subgroups and between low and high perceived stress subgroups. Furthermore, IL-6 levels were significantly increased following the calculation stress test in patients only. Conclusion: Results indicate that IBD patients may have skewed neuroendocrine-immune systems and that emotional stress may aggravate the disease. Stress-management interventions might be useful, not only for patients' quality of life (QOL) but also for disease control.
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Changes such as neuroendocrine-immune system alterations make disease exacerbation more likely.
“where changes such as neuroendocrine–immune system alterations make disease exacerbation more likely. 60”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [60]
Cites
Self-efficacy: Toward a unifying theory of behavioral change
Bandura, A. (1977) · Psychological Review · doi:10.1037/0033-295x.84.2.191 · Cited by 43,925 · see citing works
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 · see citing works
The Self-Efficacy Scale: Construction and Validation
Sherer, M., Maddux, J. E., Mercandante, B., Prentice-Dunn, S., Jacobs, B., & Rogers, R. W. (1982) · Psychological Reports · doi:10.2466/pr0.1982.51.2.663 · Cited by 4,028 · see citing works
The structure and properties of the sense of coherence scale
Antonovsky, A. (1993) · Social Science & Medicine · doi:10.1016/0277-9536(93)90033-z · Cited by 3,515 · see citing works
Encyclopedia of human behavior
(1994) · Choice Reviews Online · doi:10.5860/choice.32-0638 · Cited by 3,250 · see citing works
The salutogenic model as a theory to guide health promotion
ANTONOVSKY, A. (1996) · Health Promotion International · doi:10.1093/heapro/11.1.11 · Cited by 2,647 · see citing works
Lorig, K. R., Sobel, D. S., Stewart, A. L., Brown, B. W., Bandura, A., Ritter, P., Gonzalez, V. M., Laurent, D. D., & Holman, H. R. (1999) · Medical Care · doi:10.1097/00005650-199901000-00003 · Cited by 2,261 · see citing works
(2001) · PubMed · Cited by 1,506 · see citing works
Rouse, D. J. (1990) · Journal of Clinical Pathology · doi:10.1136/jcp.43.9.787-d · Cited by 1,194 · see citing works
Maes, M., Song, C., Lin, A., De Jongh, R., Van Gastel, A., Kenis, G., Bosmans, E., De Meester, I., Benoy, I., Neels, H., et al. (1998) · Cytokine · doi:10.1006/cyto.1997.0290 · Cited by 772 · cited 1× · see citing works
“Cytokines are mediators in the inflammatory-immune system, including tumor necrosis factor (TNF)-a, interleukin (IL)-1, IL-6, interferon (IFN)-g, IL-4, and IL-10, most of which are related to homeostatic maintenance during stress (Maes et al., 1998).”
BackgroundTumour necrosis factor alpha in stool as a marker of intestinal inflammation
Braegger, C., Nicholls, S. J., MURCH, S. H., MacDonald, T. T., & Stephens, S. (1992) · The Lancet · doi:10.1016/0140-6736(92)90999-j · Cited by 683 · see citing works
Psychological stress in IBD: new insights into pathogenic and therapeutic implications
Mawdsley, J. E., & Rampton, D. S. (2005) · Gut · doi:10.1136/gut.2005.064261 · Cited by 622 · see citing works
Cheater, F. (1997) · Clinical Effectiveness in Nursing · doi:10.1016/s1361-9004(97)80066-0 · Cited by 588 · see citing works
SILENT MYOCARDIAL ISCHAEMIA DUE TO MENTAL STRESS
Deanfield, J. E., Kensett, M. J., Wilson, R., Shea, M. J., Horlock, P. L., de Landsheere, C., & Selwyn, A. (1984) · The Lancet · doi:10.1016/s0140-6736(84)91106-1 · Cited by 413 · see citing works
The rating form of IBD patient concerns: a new measure of health status.
Drossman, D. A., Leserman, J., Li, Z. M., Mitchell, C. M., Zagami, E. A., & Patrick, D. L. (1991) · Psychosomatic Medicine · doi:10.1097/00006842-199111000-00010 · Cited by 351 · see citing works
European Journal of Gastroenterology & Hepatology
&NA; (2000) · European Journal of Gastroenterology & Hepatology · doi:10.1097/00042737-200012061-00008 · Cited by 343 · see citing works
Archivum Immunologiae et Therapiae Experimentalis
(2024) · Archivum Immunologiae et Therapiae Experimentalis · doi:10.1007/5.1661-4917 · Cited by 339 · see citing works
Elenkov, I. J. (2008) · Neurochemistry International · doi:10.1016/j.neuint.2007.06.037 · Cited by 273 · see citing works
Maunder, R., & Levenstein, S. (2008) · Current Molecular Medicine · doi:10.2174/156652408784533832 · Cited by 198 · see citing works
Disease-related worries and concerns: a study on out-patients with inflammatory bowel disease.
Moser, G., Tillinger, W., Sachs, G., Genser, D., Maier-Dobersberger, T., Spiess, K., Wyatt, J., Vogelsang, H., Lochs, H. H., & Gangl, A. (1995) · PubMed · Cited by 153 · see citing works
The relation of ulcerative colitis to psychiatric factors: a review of findings and methods
North, C. S., Clouse, R. E., Spitznagel, E. L., & Alpers, D. (1990) · American Journal of Psychiatry · doi:10.1176/ajp.147.8.974 · Cited by 137 · see citing works
A stress management programme for inflammatory bowel disease patients
Milne, B. J., Joachim, G., & Niedhardt, J. (1986) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.1986.tb01288.x · Cited by 118 · see citing works
Myren, J., Bouchier, I. A. D., Watkinson, G., Softley, A., Clamp, S. E., & de Dombal, F. T. (1984) · PubMed · Cited by 115 · see citing works
Straub, R. H., Vogl, D., Gross, V., Lang, B., Schölmerich, J., & Andus, T. (1998) · American Journal of Gastroenterology · doi:10.1111/j.1572-0241.1998.00535.x · Cited by 114 · see citing works
Cámara, R. J. A., Ziegler, R., Begré, S., Schoepfer, A. M., & von Känel, R. (2009) · Digestion · doi:10.1159/000226087 · Cited by 106 · see citing works
Vidal, À., Gómez‐Gil, E., Sans, M., Portella, M. J., Salamero, M., Pique, J. M., & Panés, J. (2008) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20388 · Cited by 98 · see citing works
The sense of coherence scale in patients with rheumatoid arthritis
Callahan, L. F., & Pincus, T. (1995) · Arthritis & Rheumatism · doi:10.1002/art.1790080108 · Cited by 95 · see citing works
The O.M.G.E. Multinational Inflammatory Bowel Disease Survey 1976-1982
Myren, J., Bouchier, I. A. D., Watkinson, G., Softley, A., Se, C., & de Dombal, F. T. (1984) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365521.1984.12199901 · Cited by 93 · see citing works
The general self-efficacy scale (GSES) : Scale development and validation
SAKANO, Y., & 東條, 光. (1986) · Medical Entomology and Zoology · Cited by 73 · see citing works
Cytokines in inflammatory bowel disease.
Kmieć, Z. (1998) · PubMed · Cited by 65 · see citing works
Yoshino, S., Fujimori, J., & Kohda, M. (1996) · PubMed · Cited by 63 · see citing works
Kresse, A. E., Million, M., Saperas, E., & Taché, Y. (2001) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.2001.281.5.g1203 · Cited by 56 · see citing works
Hirano, D., NAGASHIMA, M., Ogawa, R., & Yoshino, S. (2001) · PubMed · Cited by 47 · see citing works
Urakawa, K., & Yokoyama, K. (2009) · Industrial Health · doi:10.2486/indhealth.47.503 · Cited by 37 · see citing works
Nielsen, O. H., Brynskov, J., & Bendtzen, K. (1993) · PubMed · Cited by 30 · see citing works
Psychological stress and coping in IBD
Goodhand, J., & Rampton, D. S. (2008) · Gut · doi:10.1136/gut.2008.154229 · Cited by 28 · see citing works
Okano, Y., Utsunomiya, T., & Yano, K. (1998) · Japanese Circulation Journal-english Edition · doi:10.1253/jcj.62.173 · Cited by 24 · see citing works
HPA-axis responses during experimental colitis in the rat
Kojima, K., Naruse, Y., Iijima, N., Wakabayashi, N., Mitsufuji, S., Ibata, Y., & Tanaka, M. (2002) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00260.2001 · Cited by 23 · see citing works
Kim, S. K. W. S., Shimada, H., & SAKANO, Y. (1996) · Cited by 20 · see citing works
Acute emotional crises and ulcerative colitis
Brown, C. H. (1963) · Digestive Diseases and Sciences · doi:10.1007/bf02232035 · Cited by 16 · see citing works
Flagged first, then by citations
2 of the 43 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Labanski, A., Langhorst, J., Engler, H., & Elsenbruch, S. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.104501 · Cited by 200 · see citing works
Endogenous opiates and behavior: 2006
Bodnar, R. J. (2007) · Peptides · doi:10.1016/j.peptides.2007.09.002 · Cited by 91 · see citing works
Bhatnagar, S. (2021) · Trends in Neurosciences · doi:10.1016/j.tins.2021.09.005 · Cited by 86 · see citing works
Systematic review: the role of psychological stress in inflammatory bowel disease
Black, J., Sweeney, L., Yuan, Y., Singh, H., Norton, C., & Czuber‐Dochan, W. (2022) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17202 · Cited by 65 · see citing works
Endogenous opiates and behavior: 2011
Bodnar, R. J. (2012) · Peptides · doi:10.1016/j.peptides.2012.09.027 · Cited by 58 · see citing works
Psychological factors and stress in inflammatory bowel disease
Triantafillidis, J. K., Merikas, E., & Gikas, A. (2013) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/egh.13.4 · Cited by 50 · see citing works
Ohno, S., Takahashi, K., Inoue, A., Takada, K., Ishihara, Y., Tanigawa, M., & Hirao, K. (2017) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.12795 · Cited by 43 · see citing works
Freitas, T. H. (2015) · World Journal of Gastroenterology · doi:10.3748/wjg.v21.i21.6713 · Cited by 38 · see citing works
Chronic physical illness: a psychophysiological approach for chronic physical illness.
Purdy, J. (2013) · PubMed Central · Cited by 31 · see citing works
Sense of Coherence in Patients with Inflammatory Bowel Disease
Opheim, R., Fagermoen, M. S., Jelsness‐Jørgensen, L., Bernklev, T., & Moum, B. A. (2014) · Gastroenterology Research and Practice · doi:10.1155/2014/989038 · Cited by 28 · see citing works
The Interaction between Stress and Inflammatory Bowel Disease in Pediatric and Adult Patients
Belei, O., Basaca, D.-G., Olariu, L., Pantea, M., Bozgan, D., Nanu, A.-M., Sîrbu, I., Mărginean, O., & Enătescu, I. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13051361 · Cited by 29 · see citing works
Tamara, V. D. S. (2015) · Gastroenterology & Hepatology Open Access · doi:10.15406/ghoa.2015.02.00038 · Cited by 8 · see citing works
Stress and Gene Expression of Individuals With Chronic Abdominal Pain
Peace, R. M., Majors, B. L., Patel, N. S., Wang, D., Valle-Pinero, A. Y. D., Martino, A. C., & Henderson, W. A. (2012) · Biological Research For Nursing · doi:10.1177/1099800412458350 · Cited by 7 · see citing works
Mechanisms of chronic abdominal pain in inflammatory bowel disease and implications for treatment
Defaye, M., Nasser, Y., & Altier, C. (2025) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-025-01139-8 · Cited by 5 · see citing works
Endogenous Opioids in Crohn’s Disease
Martyniak, A., Wędrychowicz, A., & Tomasik, P. (2023) · Biomedicines · doi:10.3390/biomedicines11072037 · Cited by 5 · see citing works
Swartz, J., Alm, J. S., Theorell, T., & Lindblad, F. (2013) · Acta Paediatrica · doi:10.1111/apa.12318 · Cited by 5 · see citing works
Horanai, C., Hashimoto, H., Hisamatsu, T., Ikeuchi, H., Watanabe, K., Nanjo, S., Nezu, R., Itabashi, M., Hokari, R., Higashi, D., et al. (2024) · Digestion · doi:10.1159/000538618 · Cited by 3 · see citing works
Psychoneuroimmunologie und Autoimmunerkrankungen – eine paradigmatische Herausforderung
Schubert, C., & Hannemann, J. (2017) · Zeitschrift für Komplementärmedizin · doi:10.1055/s-0043-116647 · Cited by 2 · see citing works
Swartz, J. (2014) · KTH Publication Database DiVA (KTH Royal Institute of Technology) · Cited by 2 · see citing works
Ghose, S. M. (2018) · EngagedScholarship @ Cleveland State University (Cleveland State University) · Cited by 1 · see citing works
Nammontri, O. (2012) · UPT. Syiah Kuala University Library (Syiah Kuala University) · Cited by 1 · see citing works
On reproduction and other gender and sex-related issues in inflammatory bowel disease
Zelinková, Z. (2012) · EUR Research Repository (Erasmus University Rotterdam)
Opheim, R. (2014) · NORA - Norwegian Open Research Archives
Influência da Personalidade Tipo D na Qualidade de Vida da Doença Inflamatória Intestinal
Amorim, R., & Guerra, M. P. (2018) · Revista Iberoamericana de Diagnóstico y Evaluación - e Avaliação Psicológica · doi:10.21865/ridep47.2.04
Trotman, G. P. (2020) · University of Birmingham Institutional Research Archive (University of Birmingham)
Mądry, E., & Bartkowiak-Wieczorek, J. (2019) · Issues of Rehabilitation Orthopaedics Neurophysiology and Sport Promotion – IRONS · doi:10.19271/irons-000094-2019-27
Relationship of nighttime arousals and nocturnal cortisol in IBS and normal subjects
Bradford, M. C. (2012) · ResearchWorks at the University of Washington (University of Washington)
Neuro–Immune–Skin Axis: The Role of Neuropsychological Factors in Atopic Dermatitis
Wang, Z., Shang, D., Zhao, C., Song, T., & He, C. (2026) · Dermatitis · doi:10.1177/17103568261475840
- Authors
- Kuroki, T., Ohta, A., Sherriff-Tadano, R., Matsuura, E., Takashima, T., Iwakiri, R., & Fujimoto, K.
- Affiliations
- Hiroshima Graduate School of Health Sciences, Hiroshima-City, Japan
- Saga Medical School Hospital (JP)
- International University of Health and Welfare (JP)
- Kwassui Women's University (JP)
- Saga University (JP)
- Corresponding author
- Kuroki, Tsukasa
- Venue
- Biological Research For Nursing
- Publisher
- SAGE Publications
- Published
- 2010-11-26
- Volume
- 13
- Issue
- 4
- Pages
- 391-398
- ISSN
- 1099-8004 (ISSN-L)
- 1552-4175
- OpenAlex
- W2072868075
- Cited by
- 28
- References
- 43
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 2 · 2015: 2 · 2014: 3 · 2013: 3 · 2012: 5
- FWCI
- 1.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Research For Nursing (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (21592758, 22792209)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
- Keywords
- inflammatory bowel disease, stress response, stress coping ability, neuroendocrine-immune network, self-efficacy, sense of coherence, cortisol, ACTH, beta-endorphin, interleukin-6, perceived stress, disease activity, stress management
- MeSH terms
- Adaptation, Psychological, Adolescent, Adrenocorticotropic Hormone, Adult, beta-Endorphin, Female, Humans, Hydrocortisone, Male, Middle Aged, Surveys and Questionnaires, Stress, Psychological, Inflammatory Bowel Diseases, Interleukin-6, Case-Control Studies, Young Adult
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