title: The relationship of inflammatory bowel disease type and activity to psychological functioning and quality of life.
abstract: OBJECTIVE
  We aimed to assess the relationship of disease type and disease activity with psychological functioning and quality of life (QOL) in a population-based cohort of patients with recently diagnosed inflammatory bowel disease (IBD).
  
  
  METHODS
  A total of 388 individuals diagnosed within 7 years were recruited from a population-based registry of IBD patients for the Manitoba IBD Cohort Study. Participants completed a clinical interview and standardized self-report measures of positive and negative psychological functioning, and QOL. Disease activity was determined by symptom self-report over the prior 6 months; Harvey-Bradshaw or Powell-Tuck disease activity indices also were used. Disease type was determined through chart verification.
  
  
  RESULTS
  Seventy-four percent of Crohn's disease and 66% of ulcerative colitis participants had active disease during the previous 6 months. Multivariate regression showed that those with active disease had higher levels of distress, health anxiety, and perceived stress, lower social support, well-being and mastery, and poorer disease-specific QOL, relative to those with inactive disease. Disease type was not contributory to psychological functioning or QOL. Pain anxiety (fear of pain) and pain-specific catastrophizing were not associated with disease activity, after controlling for other psychological variables. Participants with either active or inactive disease had suboptimal general QOL.
  
  
  CONCLUSIONS
  Ulcerative colitis and Crohn's disease participants were not differentiated in their psychological profiles. Given the strong association between disease-specific QOL, psychological functioning, and disease activity, it is important to be aware of related difficulties in patients with active IBD. There is a continued impact on QOL by the disease, even when it is inactive.
authors.affiliation: Department of Psychology, University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada. lgraff@hsc.mb.ca
authors.forename: Lesley A
authors.initials: LA
authors.lastname: Graff
authors.forename: John R
authors.initials: JR
authors.lastname: Walker
authors.forename: Lisa
authors.initials: L
authors.lastname: Lix
authors.forename: Ian
authors.initials: I
authors.lastname: Clara
authors.forename: Patricia
authors.initials: P
authors.lastname: Rawsthorne
authors.forename: Linda
authors.initials: L
authors.lastname: Rogala
authors.forename: Norine
authors.initials: N
authors.lastname: Miller
authors.forename: Laura
authors.initials: L
authors.lastname: Jakul
authors.forename: Cory
authors.initials: C
authors.lastname: McPhail
authors.forename: Jason
authors.initials: J
authors.lastname: Ediger
authors.forename: Charles N
authors.initials: CN
authors.lastname: Bernstein
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000145:classification / Q000150:complications / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology