title: Stress coping, distress, and health perceptions in inflammatory bowel disease and community controls.
abstract: OBJECTIVE
  This study compares a community inflammatory bowel disease (IBD) sample of individuals with a matched non-IBD community sample of individuals on psychological functioning and health perceptions.
  
  
  METHODS
  Participants in the population-based Manitoba IBD Cohort Study (n=388) were directly compared with sex-, age-, and region-matched controls from a national random-sample health survey on the aspects of psychological health, coping, and perceived general health.
  
  
  RESULTS
  Overall, the IBD sample had lower psychological well-being and mastery, as well as higher distress than did the non-IBD controls (P<or=0.02). Those with IBD used avoidant coping significantly more often, and active coping modestly more often than did the non-IBD sample; both had similar levels of "self-soothing" behaviors. Patients with Crohn's disease and ulcerative colitis had similarly poor levels of functioning along these dimensions compared with the non-IBD sample, as did those with active disease (P<0.01). However, those with inactive disease were similar to the non-IBD sample, and had modestly higher mastery levels. Whereas nearly half of the non-IBD group reported chronic health conditions, those with IBD were threefold more likely to report poorer health (odds ratio 3.07, 95% confidence interval: 2.10-4.47). Psychological factors explained a greater amount of variance in perceived health for the IBD than for the non-IBD sample.
  
  
  CONCLUSIONS
  Those with IBD have significantly poorer psychological health than do those without IBD and view their general health status more negatively, although adaptive stress-coping strategies were similar. However, when disease is quiescent there is little detriment to functioning. Active disease should be a flag to consider psychological needs in the care of an IBD patient.
authors.affiliation: 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: Ian
authors.initials: I
authors.lastname: Clara
authors.forename: Lisa
authors.initials: L
authors.lastname: Lix
authors.forename: Norine
authors.initials: N
authors.lastname: Miller
authors.forename: Linda
authors.initials: L
authors.lastname: Rogala
authors.forename: Patricia
authors.initials: P
authors.lastname: Rawsthorne
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; D016022:Case-Control Studies; D005260:Female; D006304:Health Status; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012042:Registries; D012044:Regression Analysis; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires