title: Unfavourable outcome for women in a study of health-related quality of life, social factors and work disability in Crohn's disease.
abstract: OBJECTIVE
  The aim was to describe health-related quality of life (HRQL) and social factors, sickness and disability variables in a large population-based cohort of patients with Crohn's disease (CD).
  
  
  METHODS
  HRQL was measured with Short Form-36 in 497 adult patients with CD at three outpatient clinics. Comparisons were made with age-sex-matched background population and with ulcerative colitis (UC). Social factors, employment, sickness compensation and disability pension for CD were compared with national population registers.
  
  
  RESULTS
  CD had a greater negative effect on HRQL than did UC. This difference was more pronounced for women. Compared with background population, patients with CD had lower educational level, and had a two-fold rise in long-term sickness and disability pension rate. Women with CD had higher rates of sickness and disability than men with CD and were more often living single, though procreation was not affected.
  
  
  CONCLUSIONS
  This study characterized the burden of CD in a large population-based cohort. CD had higher impact on HRQL, compared with UC. Women with CD had worse outcome in subjective health status, but not in objective assessment of disease activity. Women also had higher rates of sickness, disability pension and single living. The mechanism underlying the sex-related inequalities in outcome for CD warrants further elucidation.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Gastroenterology and Hepatology Unit, County Hospital Ryhov, Jönköping, Sweden. henrik.stjernman@lj.se
authors.forename: Henrik
authors.initials: H
authors.lastname: Stjernman
authors.forename: Curt
authors.initials: C
authors.lastname: Tysk
authors.forename: Sven
authors.initials: S
authors.lastname: Almer
authors.forename: Magnus
authors.initials: M
authors.lastname: Ström
authors.forename: Henrik
authors.initials: H
authors.lastname: Hjortswang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003093:Colitis, Ulcerative / Q000453:epidemiology / Q000534:rehabilitation; D003424:Crohn Disease / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors; D018582:Sick Leave / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult