Psychologic stress and disease activity in patients with inflammatory bowel disease: A multicenter cross-sectional study.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
25
09
2019
accepted:
04
05
2020
entrez:
27
5
2020
pubmed:
27
5
2020
medline:
7
8
2020
Statut:
epublish
Résumé
Psychologic stress can affect the pathogenesis of inflammatory bowel disease (IBD), but the precise contribution of psychologic stress to IBD remains unclear. We investigated the association of psychologic stress with disease activity in patients with IBD, especially in terms of mental state and sleep condition. This was a multi-center observational study comprising 20 institutions. Data were collected using survey forms for doctors and questionnaires for patients, and the association of psychologic stress with clinical parameters was investigated. Mental state was evaluated using the Center for Epidemiologic Studies Depression (CES-D) scale, and sleep condition was evaluated by querying patients about the severity of insomnia symptoms. A total of 1078 IBD patients were enrolled, including 303 patients with Crohn's disease and 775 patients with ulcerative colitis. Seventy-five percent of IBD patients believed that psychologic stress triggered an exacerbation of their disease (PSTE group) and 25% did not (non-PSTE group). The CES-D scores were significantly higher for patients with clinically active disease than for those in remission in the PSTE group (median (interquartile range) = 7 (4-9.5) vs. 5 (3-7), p < .0001), but not in the non-PSTE group (5 (2-8) vs. 4 (3-7), p = 0.78). Female sex and disease exacerbation by factors other than psychologic stress were independent factors of psychologic stress-triggered disease exacerbation. Also, patients with insomnia had higher disease activity than those without insomnia, especially in the PSTE group. A worsened mental state correlates with disease activity in IBD patients, especially those who believe that their disease is exacerbated by psychologic stress.
Sections du résumé
BACKGROUND AND AIMS
Psychologic stress can affect the pathogenesis of inflammatory bowel disease (IBD), but the precise contribution of psychologic stress to IBD remains unclear. We investigated the association of psychologic stress with disease activity in patients with IBD, especially in terms of mental state and sleep condition.
METHODS
This was a multi-center observational study comprising 20 institutions. Data were collected using survey forms for doctors and questionnaires for patients, and the association of psychologic stress with clinical parameters was investigated. Mental state was evaluated using the Center for Epidemiologic Studies Depression (CES-D) scale, and sleep condition was evaluated by querying patients about the severity of insomnia symptoms.
RESULTS
A total of 1078 IBD patients were enrolled, including 303 patients with Crohn's disease and 775 patients with ulcerative colitis. Seventy-five percent of IBD patients believed that psychologic stress triggered an exacerbation of their disease (PSTE group) and 25% did not (non-PSTE group). The CES-D scores were significantly higher for patients with clinically active disease than for those in remission in the PSTE group (median (interquartile range) = 7 (4-9.5) vs. 5 (3-7), p < .0001), but not in the non-PSTE group (5 (2-8) vs. 4 (3-7), p = 0.78). Female sex and disease exacerbation by factors other than psychologic stress were independent factors of psychologic stress-triggered disease exacerbation. Also, patients with insomnia had higher disease activity than those without insomnia, especially in the PSTE group.
CONCLUSIONS
A worsened mental state correlates with disease activity in IBD patients, especially those who believe that their disease is exacerbated by psychologic stress.
Identifiants
pubmed: 32453762
doi: 10.1371/journal.pone.0233365
pii: PONE-D-19-26952
pmc: PMC7250441
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0233365Déclaration de conflit d'intérêts
The author has declared that no competing interests exist. The authors have no competing interests which can alter our adherence to PLOS ONE policies on sharing data and materials.
Références
Eur J Gastroenterol Hepatol. 2015 Jul;27(7):797-803
pubmed: 25919776
Gut. 2014 Aug;63(8):1293-9
pubmed: 24153250
Inflamm Bowel Dis. 2013 Oct;19(11):2380-6
pubmed: 23942564
Brain Behav Immun. 2011 Mar;25(3):397-407
pubmed: 21040780
Can J Gastroenterol. 2005 Sep;19 Suppl A:5A-36A
pubmed: 16151544
J Crohns Colitis. 2015 Jun;9(6):452-62
pubmed: 25855073
PeerJ. 2015 Aug 13;3:e1146
pubmed: 26290799
Inflamm Bowel Dis. 2016 Jan;22(1):164-70
pubmed: 26383912
Sleep Med. 2001 Jul;2(4):297-307
pubmed: 11438246
Support Care Cancer. 2015 Jul;23(7):1925-31
pubmed: 25487842
Inflamm Bowel Dis. 2013 Oct;19(11):2440-3
pubmed: 23945186
Brain Behav Immun. 2015 Jul;47:86-92
pubmed: 25451613
Clin Gastroenterol Hepatol. 2013 Aug;11(8):965-71
pubmed: 23376797
Sleep. 2010 Dec;33(12):1693-702
pubmed: 21120150
Am J Gastroenterol. 2003 Oct;98(10):2203-8
pubmed: 14572569
J Aging Health. 1993 May;5(2):179-93
pubmed: 10125443
Nat Rev Gastroenterol Hepatol. 2015 Apr;12(4):205-17
pubmed: 25732745
Biopsychosoc Med. 2008 Jun 06;2:11
pubmed: 18538012
Gut. 1990 Feb;31(2):179-83
pubmed: 2311975
Expert Rev Clin Immunol. 2011 Jan;7(1):29-36
pubmed: 21162647
Sleep Med. 2009 Jun;10(6):597-603
pubmed: 19403332
J Gastroenterol Hepatol. 2007 Nov;22(11):1748-53
pubmed: 17914945
J Clin Sleep Med. 2006 Oct 15;2(4):409-16
pubmed: 17557469
J Crohns Colitis. 2010 Feb;4(1):63-101
pubmed: 21122490
World J Gastroenterol. 2016 Jul 21;22(27):6296-317
pubmed: 27468219
Ann Hematol. 2014 Dec;93(12):2067-75
pubmed: 24947799
Aliment Pharmacol Ther. 2010 Jul;32(2):182-90
pubmed: 20456306
Inflamm Bowel Dis. 2015 Oct;21(10):2341-8
pubmed: 26218145
J Gastroenterol. 2016 Jul;51(7):672-81
pubmed: 26511940
Am J Gastroenterol. 2006 Apr;101(4):775-81
pubmed: 16494590
Inflamm Bowel Dis. 2010 Apr;16(4):664-9
pubmed: 19774642
J Clin Endocrinol Metab. 1998 May;83(5):1573-9
pubmed: 9589658
Clin Gastroenterol Hepatol. 2015 May;13(5):949-55
pubmed: 25283582
Scand J Gastroenterol. 1997 Oct;32(10):1013-21
pubmed: 9361174
J Gastroenterol. 2017 Nov;52(11):1149-1157
pubmed: 28168321
Inflamm Bowel Dis. 2015 Feb;21(2):400-8
pubmed: 25358064
Gastroenterology. 2013 Jan;144(1):36-49
pubmed: 23063970
J Psychiatr Res. 2011 Aug;45(8):1027-35
pubmed: 21439576