College adjustment in University of Michigan students with Crohn's and colitis.
BACKGROUND
Adjustment to college is critical for academic success. Poor college adjustment correlates with poor academic performance, low graduation rates, and poor success later in life. Limited data are available on the effects of inflammatory bowel disease (IBD) on college adjustment. We hypothesize that disease activity negatively impacts on QOL, and adversely affects college adjustment.


METHODS
Undergraduate students (6 Crohn's disease [CD], 12 ulcerative colitis [UC], 19 healthy controls) completed a standardized college adjustment survey (SACQ) and QOL instrument (SF-12). Where appropriate, disease specific activity and QOL indices were obtained (HBI, SCCAI, SIBDQ).


RESULTS
There was an inverse correlation between disease activity and college adjustment in CD and UC (R = -0.6554, p = 0.0032). IBD students had lower physical QOL (SF-12) than controls (p = 0.0009). Emotional domain of college adjustment correlated best with SIBDQ (R = 0.8228, p < 0.0001), and correlated better in CD (R = 0.8619) than UC (R = 0.7946). Mental QOL (SF-12) was worse in CD than UC (p = 0.0211), but neither differed from controls (p = 0.4, p = 0.6).


CONCLUSIONS
Students with active Crohn's and colitis adjust less well to college life. Physical and emotional factors likely contribute. More aggressive medical therapy and better emotional support before and during college may result in happier and healthier college students, leading to higher graduation rates and future success. Interventions resulting in better disease control and support systems may improve college performance and provide long-term benefits to young adults with IBD.
Department of Pediatrics, Division of Gastroenterology, University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA.
Jeremy
J
Adler
Sheela
S
Raju
Allison S
AS
Beveridge
Sijian
S
Wang
Ji
J
Zhu
Ellen M
EM
Zimmermann
D000223:Adaptation, Psychological; D000275:Adjustment Disorders / Q000523:psychology*; D000328:Adult; D001294:Attitude to Health; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000523:psychology*; D003424:Crohn Disease / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008824:Michigan / Q000453:epidemiology; D011788:Quality of Life; D013315:Stress, Psychological / Q000175:diagnosis; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires; D014495:Universities / Q000706:statistics & numerical data*