title: Stress maladjustment in the pathoetiology of ulcerative colitis.
abstract: BACKGROUND
  The aims of this study were (1) to measure levels of cytokines and stress hormones in ulcerative colitis (UC) patients and determine whether there were any disturbances in the nervous, endocrine, or immune systems, and (2) to measure the ability of UC patients to cope with stress (using a sense of coherence, SOC, test) and their perceived self-efficacy, and to elucidate their response to a stress load.
  
  
  METHODS
  We administered questionnaires to and took blood samples from 42 outpatients and eight inpatients whose UC was in remission, and 21 healthy volunteers. In addition, we evaluated blood samples from the inpatients and healthy volunteers following a mental calculation stress test.
  
  
  RESULTS
  The questionnaire results revealed that self-efficacy was significantly decreased in the patient groups. Levels of adrenocorticotropic hormone, beta-endorphin and interleukin (IL)-6 were significantly higher in the outpatient than in the control group. IL-6 levels significantly increased following the mental calculation stress test in UC patients compared with in the volunteers.
  
  
  CONCLUSIONS
  These results indicate that UC patients (1) have hypersensitive nervous, endocrine, and immune systems, and (2) this hypersensitivity was augmented by the mental calculation stress test.
authors.affiliation: Department of Internal Medicine, Saga Medical School, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Kuroki
authors.forename: Akihide
authors.initials: A
authors.lastname: Ohta
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Aoki
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawasaki
authors.forename: Nozomi
authors.initials: N
authors.lastname: Sugimoto
authors.forename: Hibiki
authors.initials: H
authors.lastname: Ootani
authors.forename: Seiji
authors.initials: S
authors.lastname: Tsunada
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000328:Adult; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000503:physiopathology* / Q000523:psychology*; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D015850:Interleukin-6 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011581:Psychological Tests; D013315:Stress, Psychological / Q000503:physiopathology*; D001615:beta-Endorphin / Q000378:metabolism
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D001615:beta-Endorphin; D000324:Adrenocorticotropic Hormone