Psychosocial Factors Affecting the Course of Inflammatory Bowel Disease

Stavroula I. Bargiota, Dionysios Sakkas, Thomas N. Hyphantis, Nikiforos V. Angeloopulos

Objective: A five year prospective study of 43 patients with Inflammatory Bowel Disease (IBD), 33 with Ulcerative Colitis and 10 with Crohn's Disease, was conducted with the purpose to investigate the role of psychosocial factors on the course and outcome of the disease.

Methods: Sociodemographic data were collected and the participants were given four psychometric instruments: the Hostility and Direction of Hostility Questionnaire (HDHQ), the Spieberger's trait anxiety (STAI-t), the Spieberger's state anxiety (STAI-s) and the Center of Epidemiological Studies-Depression Scale (CES-D). After the lapse of five years the patients were allocated to three groups according to the degree of severity of their illness (improvement, stability, deterioration). 

Results: Patients with IBD, whose condition was evaluated as deteriorated at the end of the follow-up, had initially given much higher scores on the HDHQ subscale of Paranoid Hostility than those with improvement. Patients whose course of illness showed a deterioration, had given significantly higher scores on CES-D scale, on the initial examination. Married patients who showed improvement had a significantly longer duration of marriage than the rest. Older age at the beginning of the disease was significantly related to the improvement of symptomatology than younger age.

Conclusions: Paranoid Hostility and Depressive Symptoms are predictors of more severe course of illness. Married patients with longer duration of marriage had better prognosis. Older patients had better prognosis than younger ones.