title: Stressful life events as a risk factor for inflammatory bowel disease onset: A population-based case-control study.
abstract: OBJECTIVE
  Stress is often perceived by patients with inflammatory bowel disease (IBD) as the leading cause of their disease. The aim of this study was to assess whether stress, evaluated through life event (LE) occurrence, is associated with IBD onset.
  
  
  METHODS
  Incident cases of IBD, including 167 patients with Crohn's disease (CD) and 74 with ulcerative colitis (UC), were compared with two control groups, one of 69 patients with acute self-limited colitis (ASLC) and another of 255 blood donors (BDs). Stress was assessed using Paykel's self-questionnaire of LEs. Only LEs occurring within 6 months before the onset of symptoms in IBD cases and ASLC controls and before blood donation in BD controls were registered. Anxiety and depression were assessed using Bate's and Beck's questionnaires, respectively.
  
  
  RESULTS
  In univariate analysis, occurrence of LEs was more frequent in the 6-month period prior to diagnosis in CD cases than in UC cases or either control group. After adjustment for depression and anxiety scores as well as other characteristics such as smoking status and sociodemographic features, this association appeared no longer significant. No associations were noted between occurrence of LEs and onset of UC relative to controls.
  
  
  CONCLUSIONS
  Despite its separate association with CD, LE occurrence does not appear to be an independent risk factor for IBD onset.
authors.affiliation: Registre des Maladies Inflammatoires Chroniques de l'Intestin (EPIMAD), Service d'Epidémiologie et de Santé Publique, Hôpital Calmette, CHU de Lille, 59037 Lille Cedex, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Lerebours
authors.forename: Corinne
authors.initials: C
authors.lastname: Gower-Rousseau
authors.forename: Veronique
authors.initials: V
authors.lastname: Merle
authors.forename: Franck
authors.initials: F
authors.lastname: Brazier
authors.forename: Stephane
authors.initials: S
authors.lastname: Debeugny
authors.forename: Raymond
authors.initials: R
authors.lastname: Marti
authors.forename: Jean Louis
authors.initials: JL
authors.lastname: Salomez
authors.forename: Marie France
authors.initials: MF
authors.lastname: Hellot
authors.forename: Jean Louis
authors.initials: JL
authors.lastname: Dupas
authors.forename: Jean Frederic
authors.initials: JF
authors.lastname: Colombel
authors.forename: Antoine
authors.initials: A
authors.lastname: Cortot
authors.forename: Jacques
authors.initials: J
authors.lastname: Benichou
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D008016:Life Change Events; D008297:Male; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires