title: Spiritual well-being and mental health outcomes in adolescents with or without inflammatory bowel disease.
abstract: OBJECTIVE
  The purpose of this study was threefold: 1) to describe spiritual well-being (existential and religious well-being) in adolescents with inflammatory bowel disease (IBD) versus healthy peers; 2) to examine associations of spiritual well-being with mental health outcomes (emotional functioning and depressive symptoms); and 3) to assess the differential impact of existential versus religious well-being on mental health.
  
  
  METHODS
  A total of 155 adolescents aged 11-19 years from a children's hospital and a university hospital filled out questionnaires including the Spiritual Well-Being Scale, the Children's Depression Inventory-Short Form, and the Pediatric Quality of Life Inventory. Covariates in multivariable models included demographics, disease status, and interactions.
  
  
  RESULTS
  Participants' mean (SD) age was 15.1 (2.0) years; 80 (52%) were male; and 121 (78%) were of white ethnicity. Levels of existential and religious well-being were similar between adolescents with IBD and healthy peers. In multivariable analyses, existential well-being was associated with mental health (partial R(2) change = .08-.11, p < .01) above and beyond other characteristics (total R(2) = .23, p < .01). Presence of disease moderated both the relationship between existential well-being and emotional functioning and that between religious well-being and depressive symptoms: that is, the relationships were stronger in adolescents with IBD as compared with healthy peers. Religious well-being was only marginally significantly associated with mental health after controlling for other factors.
  
  
  CONCLUSIONS
  Although both healthy adolescents and those with IBD had high levels of spiritual well-being, having IBD moderated the relationship between spiritual well-being and mental health. Meaning/purpose was related to mental health more than was connectedness to the sacred.
authors.affiliation: Department of Family Medicine, Center for the Study of Health, University of Cincinnati Academic Health Center, Cincinnati, Ohio 45267, USA. sian.cotton@uc.edu
authors.forename: Sian
authors.initials: S
authors.lastname: Cotton
authors.forename: Ian
authors.initials: I
authors.lastname: Kudel
authors.forename: Yvonne Humenay
authors.initials: YH
authors.lastname: Roberts
authors.forename: Harini
authors.initials: H
authors.lastname: Pallerla
authors.forename: Joel
authors.initials: J
authors.lastname: Tsevat
authors.forename: Paul
authors.initials: P
authors.lastname: Succop
authors.forename: Michael S
authors.initials: MS
authors.lastname: Yi
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D008297:Male; D008603:Mental Health; D009820:Ohio; D029181:Spirituality; D055815:Young Adult